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

Abstract

BACKGROUND. Pleural fluid ADA activity was shown to be a valuable biochemical marker for tuberculous pleural effusion (TPE). The goal of the present study was to investigate the usefulness of the ADA test not only in pleural fluid but in serum for the diagnosis of TPE and to evaluate if there is a dependency between ADA test and the severity of lung tuberculosis among patients with TPE in Belarusian population.
METHODS: A total of 103 consecutive patients with TPE (46), non-tuberculous effusion (30) and malignant effusion (28) were enrolled in the study: All the patients with TB pleurisy were divided into 2 groups according to the extent and type of chest radiograph changes: mild and moderate disease (23) and severe disease (23). RESULTS: Using cut-off 40 U/L, the sensitivity and specificity of pleural fluid ADA activity (pADA) in the diagnosis of TB was computed to be 93% and 96.7% respectively. Serum ADA (sADA) also demonstrated high sensitivity and specificity in TPE, 80% and 83.3% (cut-off 26 U/L). pADA activity among patients with TPE was much higher in group of severe tuberculous changes (median: 25% – 75%; 105.3: 87.4 – 121.4 U/L vs 51.2: 43.6 – 68.8 U/L). sADA level was also significantly higher in severe disease (39.2: 37.1–47.0 U/L) than in mild and moderate disease (32.3: 28.4–34.9 U/L).
CONCLUSIONS: The data obtained prove that there is an interrelationship between the severity of lung tuberculosis and ADA activity. Changes of the enzyme are the most prominent in pleural fluid of patients with bilateral involvement and multiple cavities. Determination of sADA activity for the diagnosis of TPE may be useful in case the collection of pleural fluid is made difficult.

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Citations should be made in the following way:
A. D. Tahanovich, S. Alinejad Moallem (Minsk, Belarus). Pleural fluid and serum adenosine deaminase (ADA) activities reflects the severity of lung tuberculosis. Eur Respir J 2008; 32: Suppl. 52, 2378

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