Source: Annual Congress 2008 - Diagnosis of tuberculosis: problems and perspectives
Disease area: Respiratory infections

Abstract

BACKGROUND: The aim of this study was to explore means of discriminating between different exudative pleural effusion groups, non-tuberculous and tuberculous, based on the combined function of two biological markers.
METHODS: A total of 75 consecutive patients with exudative pleural effusion were enrolled in the study: 59 men and 16 women, aged 50 years (mean). Adenosine deaminase activity and C-reactive protein concentration were measured in pleural fluid and serum of 30 patients with non-tuberculous (Non-TBP) and 45 – with tuberculous pleural effusion (TBP). ROC-curve analysis were applied to discriminate the exudative pleural effusion groups.
RESULTS: Pleural fluid and serum CRP levels were significantly higher in TBP group than in the Non-TBP group (37.1 ± 29.3 mg·L^–1 and 82.0 ± 61.0 mg·L^–1 vs 20.1 ± 18.3 mg·L^–1 and 29.8 ± 23.9 mg·L^–1, respectively). ADA level was also higher both in pleural fluid and serum of patients with TBP (84.6 ± 37.3 U·L^–1 and 35.3 ± 9.9 U·L^–1 vs 19.5 ± 10.2 U·L^–1 and 18.8 ± 5.3 U·L^–1 in Non-TBP group, respectively). The optimum cutoff value for pleural fluid CRP >21 mg·L^–1 and ADA > 40 U·L^–1 had sensitivity of 65.1 % and 93.0 %, specificity 73.3 % and 96.7%, respectively. Cutoff value for serum CRP >26 mg·L^–1 and ADA >26 U·L^–1 had sensitivity 95.6 % and 80.0 %, specificity 60.0 % and 83.3 % respectively. A correlation between serum and pleural fluid CRP and ADA levels was observed in TBP patients but not in non-TBP patients.
CONCLUSION: The combination of adenosine deaminase and C-reactive protein levels might be sufficient for discriminating between the different exudative pleural effusions.

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S. Alinejad Moallem, A. D. Tahanovich (Minsk, Belarus). An experience of discrimination of exudative pleural effusions based on C-reactive protein (CRP) and adenosine deaminase (ADA) in Belarus. Eur Respir J 2008; 32: Suppl. 52, 2384

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