Poor diagnostic value of adenosine deaminase in pleural, peritoneal & cerebrospinal fluids in tuberculosis.
Adenosine deaminase (ADA) was estimated in 84 pleural, 140 peritoneal and 136 cerebrospinal fluids to study its diagnostic usefulness as a routine test for tuberculosis. The sensitivity, specificity, positive and negative predictive values for diagnosing tuberculosis in pleural fluids (ADA > 30 U/l) was 67, 92, 78 and 87 per cent respectively, in peritoneal fluids (ADA > 15 U/1) it was 89, 81, 25 and 99 per cent respectively and in cerebrospinal fluids (ADA > 10 U/l) it was 50, 90 21 and 97 per cent respectively. The differences in mean ADA levels between tuberculous (28.0 and 19.5 U/1) and non-tuberculous (9.7 and 4.8 U/1) peritoneal and cerebrospinal fluids although statistically significant (P < 0.001), were of no practical clinical value. A wide scatter in ADA values was seen in both tuberculous and non-tuberculous fluids. ADA estimation in plasma, lymphocytes and cell fractions of fluids was also not diagnostically useful nor did it throw light on the source of elevated ADA in fluids.
Kaur
A
A
Department of Medicine, Christian Medical College Hospital, Vellore.
Basha
A
A
Ranjan
M
M
Oommen
A
A
D000243:Adenosine Deaminase / Q000032:analysis* / Q000134:cerebrospinal fluid; D000328:Adult; D001202:Ascitic Fluid / Q000201:enzymology*; D005069:Evaluation Studies as Topic; D006801:Humans; D010996:Pleural Effusion / Q000201:enzymology*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014376:Tuberculosis / Q000175:diagnosis*
D000243:Adenosine Deaminase