Ascitic fluid gamma interferon concentrations and adenosine deaminase activity in tuberculous peritonitis.
The gamma interferon (gamma-IFN) concentration and the adenosine deaminase (ADA) activity were evaluated in 30 patients with tuberculous peritonitis, 21 patients with ascites due to a malignant disorder, and 41 patients with cirrhosis. The gamma-IFN concentrations were significantly higher (p < 0.0001) in tuberculous peritonitis patients (mean: 6.70 U/ml) than in the malignant (mean: 3.10 U/ml) and cirrhotic (mean: 3.08 U/ml) groups. Use of a cut off value of > or = 3.2 U/ml gave the assay a sensitivity of 93% (25 of 27), a specificity of 98% (54 of 55), positive (P+) and negative (P-) predictive values of 96% and a test accuracy of 96%. The ADA activity was significantly (p < 0.0001) higher in the tuberculous peritonitis group (mean: 101.84 U/l) than in the control groups (cirrhosis (mean: 13.49 U/l) and malignancy (mean: 19.35 U/l)). A cut off value of > 30 U/l gave the ADA test a sensitivity of 93% (26 of 28) a specificity of 96% (51 of 53), a (P+) value of 93%, a (P-) value of 96%, and a test accuracy of 95%. There was a significant (p < 0.0001) correlation (r = 0.72) between ADA activity and gamma-IFN values in patients with tuberculous peritonitis. These results show that a high concentration of gamma-IFN in ascitic fluid is as valuable as the ADA activity in the diagnosis of tuberculous peritonitis. Both are rapid non-invasive diagnostic tests for tuberculous peritonitis.
Sathar
M A
MA
Department of Medicine, University of Natal, King Edward VIII Hospital, Durban, South Africa.
Simjee
A E
AE
Coovadia
Y M
YM
Soni
P N
PN
Moola
S A
SA
Insam
B
B
Makumbi
F
F
D000243:Adenosine Deaminase / Q000032:analysis*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001202:Ascitic Fluid / Q000737:chemistry*; D006801:Humans; D007371:Interferon-gamma / Q000032:analysis*; D008875:Middle Aged; D014395:Peritonitis, Tuberculous / Q000175:diagnosis / Q000201:enzymology; D011446:Prospective Studies
D007371:Interferon-gamma; D000243:Adenosine Deaminase