Alkaline phosphatase: Distinguishing between tuberculous and nontuberculous pleural effusion

Jadhav, Ashish Anantrao; Bardapurkar, Jayashree Suhas; Jain, Ashu

doi:10.4103/0970-2113.53230

Cited by 10 publications

(8 citation statements)

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“…ADA has been very sensitive in some studies;[ 16 ] others have noted lower results. [ 17 – 19 ] Estimation of alkaline phosphatase activity in pleural fluid was demonstrated a useful test in differentiation of tuberculous from nontuberculous pleural effusion;[ 20 ] however, this test was not done in this study. Tuberculin test was positive in 5 (25%) patients of proved tubercular effusion in the present study.…”

Section: Discussionmentioning

confidence: 99%

Role of percutaneous closed needle pleural biopsy among patients of undiagnosed exudative pleural effusion

Hira

Rai

2011

Lung India

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Background:Sometimes etiological diagnosis of pleural effusion is difficult despite cytological, biochemical and microbiological tests and labeled as undiagnosed exudative pleural effusions.Aim of present study was to make an etiological diagnosis of pleural effusion.Materials and Methods:Study group included patients of exudative pleural effusion where etiological diagnosis could not be yielded by conventional cytological, biochemical and microbiological investigations. Pleural tissue was obtained by Cope’s pleural biopsy needle and or thoracoscopy. Pleural biopsy was subjected to histopathology, ZN staining and culture to find the mycobacterium tuberculosis.Results:Out of 25 patients, 17 (68%) and 8 (32%) were male and female, respectively. Age ranged from 15 to 65 years (mean 31.72). Mean value of serum and pleural fluid LDH was 170.56 U/L and 1080.28 U/L, respectively. Histopathology of 9 (36%) showed epitheloid granuloma with caseation necrosis. In other 9 (36%) patients, epitheloid granulomas (with or without giant cells) was reported. In 5 (20%) patients, histopathology report was of nonspecific chronic inflammation. Histopathology was reported as normal in one case; it turned out to be a case of malignancy. In two (8%) patients, pleural tissue obtained was inadequate for opinions; however, other tests revealed malignancy in one and tuberculosis in other. Ziehl-Neelsen (ZN) stain was positive for AFB in two patients and culture of pleural tissue showed presence of Mycobacterium tuberculosis in three patients.Conclusions:The role of percutaneous closed needle biopsy of pleura among patients of undiagnosed exudative pleural effusion is still accepted as a diagnostic tool, as this may lead to a specific diagnosis among 76% of cases. This is of particular importance in a developing country like India where the facilities of thoracoscopy and imaging guided cutting needle biopsies are not easily available.

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Section: Discussionmentioning

confidence: 99%

Role of percutaneous closed needle pleural biopsy among patients of undiagnosed exudative pleural effusion

Hira

Rai

2011

Lung India

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“…Pleural ALP determined exudative effusion with a sensitivity of 82% and specificity of 76%, despite its lower contribution to diagnosis [8]. Similarly, Jadhav et al proved that pleural ALP made the differential diagnosis of tuberculous and non-tuberculous pleural effusions with a sensitivity of 90% and specificity of 80% [13]. In contrast, Mushtaq showed that ALP had phy (EBUS).…”

Section: Discussionmentioning

confidence: 99%

Serum alkaline phosphatase may play a role in the differential diagnosis of sarcoidosis and tuberculosis?

Önür

Iliaz

İliaz

et al. 2016

1.13 Clinical Problems - Other

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Background: Reaching the differential diagnosis of tuberculosis and sarcoidosis can be difficult due to granulomatous inflammation. The aim of this study was to determine alkaline phosphatase (ALP) activity in serum for the differential diagnosis of tuberculosis and sarcoidosis. Methods: This study comprised 242 subjects: 105 acid-fast bacilli (AFB) positive and/or culture-positive patients with pulmonary tuberculosis, 90 patients with biopsyproven sarcoidosis and a control group consisting of 47 healthy controls were included. ALP activity was measured in serum at the first admission of the patients. Results: The mean serum ALP was 112.74±55.14 IU/L in pulmonary tuberculosis, 76.14±34.23 IU/L in sarcoidosis, and 66.87±18.49 IU/L in the control group, respectively. There was a statistically significant difference between the patient population and the control group (P = 0.03). Also, there was a statistically significant difference between the tuberculosis and sarcoidosis groups (P = 0.034). According to the comparison of tuberculosis and sarcoidosis, the cutoff value was determined as 71.50 IU/L, which had sensitivity of 80%, specificity of 51%, PPV of 66%, NPV of 69%, accuracy of 67%, and the AUC was 0.728. Conclusion: ALP, as a little-known marker for tuberculosis and sarcoidosis, was significantly increased in the pulmonary tuberculosis group compared with the sarcoidosis group. As such, it may be a useful tool for the differentiation of tuberculosis and sarcoidosis.

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“…However, Ashish Anantrao Jadhay et al [19] had reported that higher proportion of pleural to serum alkaline phosphatase is helpful to differentiate tuberculous pleural effusion from non-tuberculous pleural effusion. It was reported in personalized health information in review article [20] that alkaline phosphatase is high in tuberculosis. Therefore, alkaline phosphastase is raided in tuberculosis not necessarily to involve the liver.…”

Section: Discussionmentioning

confidence: 99%

Disseminated Tuberculosis - A Case Study

Thanabalan¹

2014

J Metabolic Synd

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Disseminated Tuberculosis (TB) is a potentially lethal disease if not diagnosed and treated early.It still remains if the presentation is non-specific, unusual and the relevant facts are overlooked. However, a high index of clinical suspicion and early diagnosis and timely institution of anti-tuberculosis treatment is life-saving. Here we did a case study of disseminated tuberculosis with unusual presentation.

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Alkaline phosphatase: Distinguishing between tuberculous and nontuberculous pleural effusion

Cited by 10 publications

References 9 publications

Role of percutaneous closed needle pleural biopsy among patients of undiagnosed exudative pleural effusion

Role of percutaneous closed needle pleural biopsy among patients of undiagnosed exudative pleural effusion

Serum alkaline phosphatase may play a role in the differential diagnosis of sarcoidosis and tuberculosis?

Disseminated Tuberculosis - A Case Study

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