Adenosine deaminase and carcinoembryonic antigen in pericardial effusion diagnosis, especially in suspected tuberculous pericarditis.

Koh, Kwang Kon; Kim, E J; Cho, C H; Choi, Myung Ja; Cho, S K; Kim, S S; Kim, M H; Lee, C J; Jin, Sung Hoon; Kim, J M

doi:10.1161/01.cir.89.6.2728

Cited by 93 publications

(51 citation statements)

References 22 publications

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“…28,29 Imaging by CT scanning or MRI can also be used but is seldom available in rural areas in the developing world. Signs and symptoms of tuberculous pericarditis are usually nonspecific and vague, [22][23][24] and the diagnosis may be overlooked until circulatory signs develop.…”

Section: Diagnosis Of Pericardial Effusionmentioning

confidence: 99%

Tuberculous Pericarditis

2005

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Background-The incidence of tuberculous pericarditis is increasing in Africa as a result of the human immunodeficiency virus (HIV) epidemic. The primary objective of this article was to review and summarize the literature on the pathogenesis, diagnosis, and management of tuberculous pericarditis. Methods and Results-We searched MEDLINE (January 1966 to May 2005 and the Cochrane Library (Issue 1, 2005) for information on relevant references. A "definite" diagnosis of tuberculous pericarditis is based on the demonstration of tubercle bacilli in pericardial fluid or on a histological section of the pericardium; "probable" tuberculous pericarditis is based on the proof of tuberculosis elsewhere in a patient with otherwise unexplained pericarditis, a lymphocytic pericardial exudate with elevated adenosine deaminase levels, and/or appropriate response to a trial of antituberculosis chemotherapy. Treatment consists of the standard 4-drug antituberculosis regimen for 6 months. It is uncertain whether adjunctive corticosteroids are effective in reducing mortality or progression to constriction. Surgical resection of the pericardium remains the appropriate treatment for constrictive pericarditis. The timing of surgical intervention is controversial, but many experts recommend a trial of medical therapy for noncalcific pericardial constriction, and pericardiectomy in nonresponders after 4 to 8 weeks of antituberculosis chemotherapy.

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Section: Diagnosis Of Pericardial Effusionmentioning

confidence: 99%

Tuberculous Pericarditis

2005

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“…Because of the typical nature of chest pain and febrile illness in this young female patient, we initially suspected simple viral pericarditis complicated with pericardial effusion and tamponade. However, unexpectedly elevated CEA level of pericardial fluid and mediastinal mass lesion on chest CT raised the possibility of malignant pericardial effusion [2]. Multimodality imaging tests including cardiac MRI and fusion PET-CT were performed for further evaluation of the mediastinal mass.…”

Section: Discussionmentioning

confidence: 99%

Bronchogenic cyst masquerading as malignant pericardial effusion with tamponade

Choi

Kim

et al. 2017

Yeungnam Univ J Med

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We report on a rare case involving a 23-year-old female patient with mediastinal cystic mass complicated with acute pericarditis and cardiac tamponade. Pericardial fluid demonstrated lymphocyte-predominant exudate and the level of carcinoembryonic antigen (CEA) was unexpectedly elevated. Successive aspiration of mediastinal cystic mass revealed a very high level of CEA (>100,000 U/mL) and carbohydrate antigen 19-9 (>15,000 ng/mL). This patient was clinically diagnosed as an infected bronchogenic cyst complicated with pericarditis and cardiac tamponade. The treatment resulted in alleviation of her symptoms.

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“…Abdominal tuberculosis involves omentum, intestinal tract, liver, spleen and genitourinary tract, which occurs in 1% -4% of patients with pulmonary tuberculosis (10). Although abdominal tuberculosis most commonly exists in developing countries with growing incidence of immunosuppression caused by diseases like HIV orchemotherapy, the prevalence is increasing in modern countries as well (11,12). The disease has no characteristic signs, symptoms and paraclinic findings.…”

Section: Discussionmentioning

confidence: 99%

“…However, abdominal pain, fever, night sweats, ascites, abdominal distention, female infertility and pelvic mass (shown in ultrasonography and CT scan) may be present in some patients. Moreover, PPD skin test may be positive (12), also ascites fluid might also be positive for adenosine deaminase (13). Given the case under study, except for positive PPD there were no specific signs and/or symptoms.…”

Section: Discussionmentioning

confidence: 99%

Peritoneal Tuberculosis: An Uncommon Disease Calling for Close Scrutiny

Jalali

Mashuri

Tamannaie

et al. 2013

Arch Clin Infect Dis

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Introduction: Tuberculosis (TB) is a disease with diverse clinical manifestations. It typically attacks the lungs (pulmonary); however, it may also affect other parts of the body (extrapulmonary) with or most commonly without lung involvement. Notable extrapulmonary infection sites include pleura, central nervous system, lymphatic system, genitourinary system, bones and joints, and abdomen. Abdominal TB is one of the most prevalent forms of extrapulmonary presentations of this variable disease. Given the patients with abdominal complaints especially in developing countries, where the disease is endemic, it should be kept in mind that abdominal TB has numerous differential diagnoses. Case Presentation: Our case is a 46 year-old female with left upper abdominal pain and mass sensation, with no associated signs or symptoms, but negative family history of TB and carcinoma. The patient underwent several diagnostic procedures so that the ultimate cause for her abdominal pain would be discovered among various existing differential diagnoses. Discussion: Peritoneal TB, although not very common, is still the important cause of not only abdominal symptoms but also female infertility. The need to pay more accurate attention to peritoneal TB in endemic areas, especially in young patients considered to have peritoneal carcinomatosis, seems very important. Keywords: Peritonitis; Tuberculous; Disease DiagnosisImplication for health policy/practice/research/medical education: Tuberculosis is a disease with diverse clinical presentations. It typically attacks the lungs, but it may involve other parts of the body (extrapulmonary) with or most commonly without lung involvement.

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Adenosine deaminase and carcinoembryonic antigen in pericardial effusion diagnosis, especially in suspected tuberculous pericarditis.

Abstract: Pericardial fluid ADA and CEA are useful for the differential diagnosis of pericardial effusion of various causes. They also have great value in early diagnosis of TP, particularly when the results of other clinical and laboratory tests are negative.

Cited by 93 publications

References 22 publications

Tuberculous Pericarditis

Tuberculous Pericarditis

Bronchogenic cyst masquerading as malignant pericardial effusion with tamponade

Peritoneal Tuberculosis: An Uncommon Disease Calling for Close Scrutiny

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