scholarly journals CORRELATION BETWEEN ADENOSINE DEAMINASE ACTIVITY IN PLEURAL FLUID AND SERUM OF PATIENTS WITH PLEURAL EFFUSION

2018 ◽  
Vol 24 (2) ◽  
pp. 180
Author(s):  
Pande Putu Ayu Patria Dewi ◽  
Aryati Aryati ◽  
Leonita Anniwati ◽  
Isnin Anang Marhana
Keyword(s):  
Pleural Effusion ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Gastrointestinal Disease ◽  
Pleural Space ◽  
Systemic Diseases ◽  
Cross Sectional ◽  
Adenosine Deaminase Activity ◽  
Abnormal Accumulation ◽  
Cross Sectional Design

Pleural effusion is an abnormal accumulation of fluid in the pleural space resulting from increased production of fluid or decreased resorption of fluid in the pleural space. Pleural effusion can be caused by infectious diseases, malignancies, collagen disease, gastrointestinal disease, heart disease and other causes such as medication. Adenosine Deaminase (ADA) is an enzyme involved in the catabolism of purines. This enzyme can be measured in pleural fluid, serum and other body fluids such as cerebrospinal and ascites fluid. The aim of this study was to analyze the correlation between adenosine deaminase activity in pleural fluid and serum in patients with pleural effusion. This research was an observational study with a cross-sectional design. Examination of ADA activity was performed in pleural fluid and serum. Adenosine deaminase activity was examined using photometric methods (Non-Giusti), using Diazyme reagent by TMS 24i Premium. Subjects were 46 patients with pleural effusion caused by malignancies, tuberculosis and systemic diseases. Mean±SD ADA activity for all pleural effusion samples in serum was 13.037± 8.365 (0.5-34.1) U//L and pleural fluid 30.843± 28.860 U//L (1.3-140.8). No correlation between ADA activity in serum and pleural fluid (r=0.173, p= 0.252) was found in all samples. No correlation between ADA activity in serum and pleural fluis was found in malignancies (r=0.109, p=0.630), tuberculosis (r= 0.366, p=0.123), systemic diseases (r =0.466, p=0.429) and non-tuberculosis group (r=0.126, p=0.532). There was no correlation between pleural fluid ADA activity and serum. 

scholarly journals Diagnostic significance of pleural fluid adenosine deaminase activity in tuberculous pleurisy

1970 ◽  
Vol 5 (1) ◽  
pp. 1-5
Author(s):  
Sharmeen Ahmed ◽  
Reaz Fatema ◽  
Ahmed Abu Saleh ◽  
Mumayun Sattar ◽  
Md Ruhul Amin Miah
Keyword(s):  
Pleural Effusion ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Colorimetric Method ◽  
Diagnostic Methods ◽  
Test Accuracy ◽  
Diagnostic Significance ◽  
Tuberculous Pleural Effusion ◽  
Adenosine Deaminase Activity ◽  
Significant Difference

Diagnosis of tuberculous pleural effusion (TPE) is difficult because of its non-specific clinical presentation and insufficient efficiency of conventional diagnostic methods. The study was carried out to evaluate the utility of adenosine deaminase (ADA) activity in pleural fluid for the diagnosis of TPE. ADA activity was measured in pleural fluid of 103 pleural effusion patients by colorimetric method using a commercial ADA assay kit. The diagnosis of TPE was made from pleural fluid examinations (including cytology, biochemistry, and bacteriology) and pleural biopsy. Patient with negative result of this methods were diagnosed by response of empirical treatment. Out of 130 cases, 62 (61.1%) had TPE and the remaining 41 (39.8%) had pleural effusion due to non tuberculous diseases. There was statistically significant difference (p < 0.001) between the mean of pleural fluid ADA levels (70.82±22.54 U/L) in TPE group and (30.07±22.93 U/L) in non-TPE group. Of 62 TPE cases, microscopy for AFB and culture for M.tuberculosis in pleural fluid revealed positivity in 9.6% and 22.5% cases respectively, and biopsy of pleura showed typical epithelioid granuloma in only 43.5% cases. The cut-off value of ADA for diagnosing TPE was 40 U/L using a ROC curve, with a sensitivity of 94% and specificity of 88%. Positive and negative predictive value of ADA assay were 92% and 90% respectively. The overall test accuracy was 90%. Pleural fluid ADA assay is therefore a simple, rapid, highly sensitive and specific adjunct test for diagnosis of TPE. DOI: http://dx.doi.org/10.3329/imcj.v5i1.9852   Ibrahim Med. Coll. J. 2011; 5(1): 1-5 Keywords: Pleural fluid; adenosine deaminase; tuberculous pleural effusion

scholarly journals Diagnostic Accuracy of Pleural Fluid Adenosine Deaminase Level Test in Tuberculous Pleural Effusion

2017 ◽  
Vol 37 (4) ◽  
pp. 278-282
Author(s):  
Puspa Rosfadilla ◽  
Widirahardjo Widirahardjo ◽  
Fajrinur Syarani ◽  
Erna Mutiara
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pleural Effusion ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Predictive Value ◽  
Exclusion Criteria ◽  
Diagnostic Modality ◽  
Cross Sectional ◽  
Tuberculous Pleural Effusion ◽  
Hospital Research

Background: Tuberculous pleural effusion is a paucibacillary manifestation of tuberculosis, so isolation of Mycobacterium tuberculosis is difficult, biomarkers being an alternative for diagnosis. Adenosine deaminase has the potential to optimize the diagnostic approach of tuberculous pleural effusion. Methods: This study is a diagnostic test observational (cross-sectional), which included 35 inpatient samples that meet inclusion and exclusion criteria from H. Adam Malik Medan General Hospital. Research began on February 1st until July 31st 2016 to examine 10 cc of pleural fluid specimens for the levels of Adenosine deaminase. Results: There are significant differences in the levels of adenosine deaminase from tuberculous and non-tuberculous pleural effusion (P=0.001). In the cut-off point 36.55 IU/L, level of sensitivity 95.8%, specificity 90.99%, positive predictive value 95.8%, negative predictive value 90.99%, and accuracy 94.2% of pleural fluid adenosine deaminase level test in tuberculous pleural effusion. Conclusion: Adenosine deaminase pleural fluid can be a diagnostic modality that is easy, fast, relatively affordable and applicable in the diagnosis of tuberculous pleural effusion. (J Respir Indo. 2017; 37(4): 278-82)

scholarly journals Diagnostic Accuracy of Adenosine deaminase enzyme (ADA) in the diagnosis of tuberculous pleural effusion

2020 ◽  
Vol 24 (4) ◽  
pp. 311-315
Author(s):  
Haroon Ur Rasheed ◽  
Ejaz Hassan Khan ◽  
Mohsin Shafi ◽  
Ahmad Rafiq ◽  
Ambreen Ali ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Predictive Value ◽  
Colorimetric Method ◽  
Pleural Effusions ◽  
Cross Sectional ◽  
Tuberculous Pleural Effusion ◽  
Systemic Examination

Objective: To study the diagnostic accuracy of Adenosine deaminase enzyme (ADA) in the diagnosis of tuberculous pleural effusion (TPE).Material and Methods: It was a cross-sectional descriptive study conducted in the Pulmonology departments of Lady Reading and Khyber Teaching Hospital Peshawar and department of Pathology, Khyber Medical College, Peshawar from April 2015 to Jan 2016. A total of 210 tuberculous and non-tuberculous pleural effusion patients were selected through consecutive non-probability sampling techniques. After physical and systemic examination, 3cc of pleural fluid was taken. ADA was estimated by Non-Guisti and Galanti method through the simple colorimetric method. All the data was entered in a specially designed proforma and SPSS v16 was used for statistical analysis.Results: Out of 210 tuberculous and non-tuberculous pleural effusions, the commonest cause of pleural effusion was tuberculosis followed by malignancy. In our study, Pleural fluid ADA levels have sensitivity, specificity, positive predictive value( PPV), and negative predictive value (NPV) of 95.5%, 92.3%, 92.4%, and 96% respectively in differentiating tuberculous pleural effusions from non-tuberculous lymphocytes predominant pleural effusions. Conclusion: Tuberculosis is the commonest infectious disease worldwide. A pleural fluid ADA level of ≥ 35 U/L in lymphocyte-predominant effusions makes mycobacterium tuberculosis most likely etiology. This test is not only very sensitive and specific but also it is very cheap, quick, and easy to perform by routine colorimetric method.  

scholarly journals Evaluation of adenosine deaminase activity in serum and pleural fluid of pulmonary tuberculosis patients with pleural effusion

2018 ◽  
Vol 6 (10) ◽  
pp. 3358
Author(s):  
Uma D. Malempati ◽  
Kusuma K. Medooru
Keyword(s):  
Pleural Effusion ◽  
Pulmonary Tuberculosis ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Treatment Initiation ◽  
Healthy Controls ◽  
Tuberculosis Patients ◽  
Valuable Adjunct ◽  
Adenosine Deaminase Activity ◽  
And Control

Background: In endemic regions, a high adenosine deaminase (ADA) activity in lymphocyte predominant exudate is a valuable adjunct in diagnostic evaluation and treatment initiation in tuberculous pleural effusion. Tuberculosis is highly endemic in India, requiring prompt diagnosis, effective treatment and control of the disease. The present study was aimed to evaluate the serum and pleural fluid ADA activities in pulmonary tuberculosis patients with pleural effusion.Methods: This study includes a total of 240 subjects; 40 pulmonary tuberculosis patients (PTB), 40 PTB with pleural effusion (PE), 40 PTB treated for one month, 40 healthy controls, 40 transudative PE patients and 40 nontuberculous exudative PE patients, between 20-70 years of age. ADA activity was estimated by the Guisti-Galanti method along with routine parameters in all study subjects.Results: Serum ADA activity was significantly higher (p<0.001) in PTB with PE (37.68±12.42U/L) than healthy controls (12.15±5.38U/L), transudative PE (22.43±9.12U/L), nontuberculous exudative PE (16.92±4.98U/L) and treated PTB (19.39±4.54U/L). Pleural fluid ADA activity was significantly higher (p<0.0001) in PTB with PE (78.94±36.75U/L) than in transudative PE (11.25±3.12U/L) and nontuberculous exudative PE (17.56±10.42U/L). ADA activity was significantly higher (p<0.001) in pleural fluid than serum in PTB with PE. Lymphocyte percentage was significantly higher (p<0.001) in pleural fluid (86.57±9.64) than peripheral blood (37.48±8.49) in PTB with PE.Conclusions: The pleural fluid ADA activities were elevated in lymphocyte predominant exudates of PTB patients with PE from endemic regions, prompting treatment initiation in high suspicion cases with elevated ADA activity.

scholarly journals Role of pleural fluid adenosine deaminase activity and lymphocytosis in the etiological diagnosis

2016 ◽  
Vol 6 (12) ◽  
pp. 1008-1012
Author(s):  
K Pande ◽  
S Shrestha ◽  
A Shrestha ◽  
KBR Prasad ◽  
SK Rauniyar ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Adenosine Deaminase ◽  
Predictive Value ◽  
Medical Condition ◽  
Colorimetric Method ◽  
Differential Count ◽  
P Value ◽  
City Hospital ◽  
Cross Sectional ◽  
Adenosine Deaminase Activity

Background: Pleural effusion is a common medical condition with many possible underlying etiologies. However, Tuberculosis is the most common cause of pleural effusion especially in countries like Nepal. Pleural uid lymphocytosis is seen in tuberculosis, malignancy and few auto-immune diseases. Adenosine Deaminase activity (ADA) level in tubercular pleural effusion is markedly increased compared to non-tubercular effusions. ADA estimation being a simple colorimetric method is suitable for the rapid diagnosis of tubercular effusion. This study aims to correlate the diagnostic ef cacy of ADA with the value of differential count (lymphocytosis) in establishing different etiology of pleural effusion. Materials and Methods: This is a cross sectional study of 50 cases with pleural effusion carried out in the department of Pathology, Green city hospital for the duration of Twenty one month’s dating from October 2014 to July 2016 AD. Results: Of all, tubercular pleural effusion accounted for 26%. ADA level was raised (≥40U/L) in 92% of Tubercular pleural effusion. The sensitivity and speci city of ADA alone to diagnose tubercular pleural effusion was 92% each and when lymphocytosis alone was considered sensitivity was 85% with speci city of 32% whereas the combined effect of both ADA with lymphocytosis was 100% (sensitivity) and 87% (speci city), 83% (positive predictive value) and 100% (negative predictive value) respectively with statistically signi cant p value (<0.05). Conclusion: We can conclude that the combination of pleural uid differential count (lymphocytosis >50%) and ADA level >40U/L provides with much more positive result than each component alone in differentiating tubercular effusion from other etiologies. 

scholarly journals Nilai Diagnostik Adenosine Deaminase (ADA) Cairan Pleura pada Penderita Efusi Pleura Tuberkulosi

2019 ◽  
Vol 2 (2) ◽  
pp. 35
Author(s):  
Rizki Nur Amalia ◽  
Isnu Pradjoko
Keyword(s):  
Pleural Effusion ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Diagnostic Methods ◽  
Cross Sectional ◽  
Kappa Test ◽  
Significant Difference ◽  
Observational Statistic ◽  
Effusion Method ◽  
Level Of Agreement

Background: Tuberculosis pleural effusion is the most common extrapulmonary TB after lymphadenitis TB. Limited diagnostic methods make TB pleural effusion hard to diagnose. Adenosine deaminase ADA is an enzyme in purin catabolism process which catalyze adenosine into inosine and deoksiadenosine into deoksiinosin. This process is important in lymphoid cell differentiation. ADA is elevated in TB pleural effusion. Method: This study was a cross sectional analytic observational. Statistic analysis was using two independent samples T test. ROC curve was used to determine cut off value of ADA. Kappa test was used to determined the level of agreement of ADA cut off value. Results: Forty eight samples were included in this study, 18 samples with TB pleural effusion and 30 samples with non TB pleural effusion. There was significant difference between pleural fluid ADA in TB and non TB. Positivity of AFB sputum and MTB culture did not show any significant differences. Cut off ADA value for TB pleural effusion diagnosis was 39,19 with sensitivity 88,9% and spesificity 90%. Conclusion: Examination of ADA level in pleural fluid is a usefull tool to diagnose TB pleural effusion.

scholarly journals Study of Diagnostic Importance of Adenosine Deaminase (ADA) Level in Pleural Effusions

2015 ◽  
Vol 2 (2) ◽  
pp. 104 ◽  
Author(s):  
Sachin Kate ◽  
B. K. Mutha ◽  
Gauri Kulkarni ◽  
Chetan Mahajan ◽  
Sushma Dugad
Keyword(s):  
Pleural Effusion ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Tertiary Care ◽  
High Sensitivity ◽  
Pleural Effusions ◽  
Tertiary Care Centre ◽  
Adenosine Deaminase Activity

<strong>Introduction</strong>: Pleural effusion is the abnormal accumulation of fluid in the pleural space. TB is the most common cause of pleural effusion worldwide (30-60%). The pleural fluid activity of adenosine deaminase (ADA) is one of the best, providing reliable basis for a treatment decision, particularly in excluding the diagnosis of tuberculosis, due to its high sensitivity.<strong> Aims and Objectives</strong>: To assess the importance of adenosine deaminase(ADA) level in the diagnosis of pleural effusion. To assess Adenosine Deaminase Activity (ADA) in tuberculosis pleural effusion and assess the sensitivity and specificity of ADA levels. <strong>Materials and Methods</strong>: This study was performed at the Department of Pulmonary Medicine at tertiary care centre. The study comprised of 75 patients of pleural effusion having Age &gt; 14 years, Clinical and Radiological evidence of Pleural Effusions&amp;Patients willing for ADA examination. Patients having Age &gt; 65 years, minimal nontappable effusion, not giving consent for ADA examination patient were excluded from the study. Detailed history, thorough physical examination, radiological findings, haematological and biochemical findings were recorded in the proforma. Pleural aspiration was performed on all patients. Macroscopic findings, cytological, microbiological and biochemical analysis of pleural fluid were performed in all patients including ADA level. PCR for Mycobacterium tuberculosis was also assessed in pleural fluid. Pleural fluid Adenosine deaminase level was measured by Giusti and Galanti method. <strong>Result</strong>: In our study out of 45 patients with tuberculosis pleural effusion ADA was more than 40IU/L in 42 (93.33%) and less than40IU/L in 3 (6.66 %). Our study showed a mean ADA of 107.7 IU/L Using a cut off of greater 40IU/L we got a sensitivity and specificity of 93.3% and 90% respectively and Positive predictive value 93.3% and Negative predictive value 90%. <strong>Conclusion</strong>: Pleural fluid ADA activity has been shown to be a valuable biochemical marker that has a high sensitivity and specificity for TB diagnosis.

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