The usefulness of adenosine deaminase in the diagnosis of tuberculous pericarditis

Abstract

SUMMARYThe objective of this study was to evaluate the adenosine deaminase (ADA) activity usefulness in the diagnosis of tuberculous pericarditis (TP), comparing its value with pericardial effusions (PE) caused by other pericardial diseases. A retrospective casecontrol study was conducted with nine cases of TP and 39 other than TP diseases (12 neoplastic, 11 septic and 16 unknown origin). Every patient included in this study had PE samples submitted to ADA activity measures and microbiological analysis, and then had pericardial tissue samples submitted to microbiological and histopathological examination. Considering the value of 40 U/L as the cut-off for the diagnosis of TP, the specificity and sensitivity were respectively of 72% and 89%. The specificity of ADA activity for the TP was best applied in the differential diagnosis from PE of unknown origin. The present study demonstrates the clinical value of the measurement of ADA activity in PE in the diagnosis of TP.

Advances in the diagnosis of tuberculosis

“…Cerebrospinal fluid for pressure, cellularity, protein, glucose, 46 MTB (microscopy, culture 47 Pericardial tissue/fluid for bacteriology, histology, 76,77 IGRA, 78,79 and ADA. [80][81][82] Echocardiography, [83][84][85] CT and MRI (pericardial effusion and thickening), 86…”

Predictive factors for unfavorable outcomes of tuberculous pericarditis in human immunodeficiency virus–uninfected patients in an intermediate tuberculosis burden country

“…A cutoff value of 40 U/L in the pericardial fluid is considered to have a specificity and sensitivity of 72% and 89% in diagnosis of TB pericarditis, respectively [28]. A median ADA of 97 U/L in the pericardial fluid was seen in the patients of this study.…”

Utility of serum ADA estimation in the diagnosis of extrapulmonary tuberculosis

“…The importance of ADA in body fluids has already been established for the diagnosis of pleural and other extra pulmonary TB, where sputum often leads to inconclusive results. [4][5][6][7] This observation of increased ADA activity in body fluids is believed to be due to migration of T lymphocytes to the effusion sites. 9 However, very limited studies are available for ADA levels in serum.…”

“…Levels of adenosine deaminase (ADA) in body fluids especially pleural fluid has proven to be highly sensitive and specific for diagnosis of extra pulmonary TB. [4][5][6][7] However, in some cases diagnosis of EPTB may require invasive procedures like FNAC or biopsy. So, serum ADA seems to be a better alternative to fluid ADA for the diagnosis of EPTB.…”