title: Guillain-Barré syndrome and tularemia pleuritis with high adenosine deaminase activity in pleural fluid.
abstract: A 56-year-old man suffered from prolonged fever, sore throat and cough, followed by pleural effusion and reversible progressive ascending muscle weakness. The condition fulfilled the diagnostic criteria of Guillain-Barré syndrome. Tuberculosis was initially suspected because of lymphocyte predominance and high adenosine deaminase activity in the pleural fluid. Later, an agglutination titer of 10,240 to Francisella tularensis antigen was found and an infected hare exposure could be identified. Thus, the activity of adenosine deaminase may be high also in tularemia pleuritis.
authors.affiliation: Department of Internal Medicine, University of Oulu, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Syrjälä
authors.forename: P
authors.initials: P
authors.lastname: Koskela
authors.forename: P
authors.initials: P
authors.lastname: Kujala
authors.forename: V
authors.initials: V
authors.lastname: Myllylä
mesh_terms: D000243:Adenosine Deaminase / Q000032:analysis*; D003937:Diagnosis, Differential; D006801:Humans; D008214:Lymphocytes / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009700:Nucleoside Deaminases / Q000032:analysis*; D010996:Pleural Effusion / Q000201:enzymology* / Q000209:etiology; D011129:Polyradiculoneuropathy / Q000175:diagnosis / Q000209:etiology*; D014406:Tularemia / Q000150:complications* / Q000175:diagnosis
chemical_list: D009700:Nucleoside Deaminases; D000243:Adenosine Deaminase