title: Diagnostic value of pleural fluid interferon-gamma and adenosine deaminase in patients with pleural tuberculosis in Qatar.
abstract: OBJECTIVE
  To investigate the diagnostic utility of interferon-gamma (IFN-γ) and adenosine deaminase (ADA) in tuberculous pleural effusions by determining the best cutoff levels of these two markers for pleural tuberculosis, in the context of the local epidemiological settings in Qatar.
  
  
  METHODS
  We prospectively studied IFN-γ and ADA levels in the pleural fluid of patients presenting to Hamad General Hospital between June 1, 2009 and May 31, 2010.
  
  
  RESULTS
  We studied 103 patients with pleural effusions, 72 (69.9%) with pleural tuberculosis, and 31 (30.1%) with nontuberculous etiologies. The mean IFN-γ concentration for the group with tuberculous effusions was significantly higher than that in the group with nontuberculous effusions (1.98 ± 81 vs 0.26 ± 10 pg/mL [P < 0.0001]). The mean ADA activity for the tuberculous effusions group was significantly higher than that in group with nontuberculous effusions (41.30 ± 20.09 vs 14.93 ± 14.87 U/L [P < 0.0001]). By analysis of receiver operating characteristic (ROC) curves, the best cutoff values for IFN-γ and ADA were 0.5 pg/mL and 16.65 U/L, respectively. The results for IFN-γ vs ADA were: for sensitivity, 100% vs 86%, respectively; for specificity, 100% vs 74%, respectively; for positive predictive value, 100% vs 88.5%, respectively; and for negative predictive value, 100% vs 69.7%, respectively.
  
  
  CONCLUSIONS
  IFN-γ and ADA could be used as valuable parameters for the differentiation of tuberculous from nontuberculous effusion, and IFN-γ was more sensitive and specific for tuberculous effusion than ADA.
authors: Department of Medicine, Hamad General Hospital, Doha, Qatar.
authors: Fahmi Yousef
authors: FY
authors: Khan
authors: Maha
authors: M
authors: Hamza
authors: Aisha Hussein
authors: AH
authors: Omran
authors: Muhannad
authors: M
authors: Saleh
authors: Mona
authors: M
authors: Lingawi
authors: Adel
authors: A
authors: Alnaqdy
authors: Mohamed Osman Abdel
authors: MO
authors: Rahman
authors: Hasan Syed
authors: HS
authors: Ahmedullah
authors: Alan
authors: A
authors: Hamza
authors: Ahmed Al
authors: AA
authors: Ani
authors: Mehdi
authors: M
authors: Errayes
authors: Mona
authors: M
authors: Almaslamani
authors: Ahmed Ali
authors: AA
authors: Mahmood
keywords: malignant effusion; parapneumonic effusion; pleural effusion
references: Chest. 2003 Mar;123(3):740-4
references: 12628872
references: East Mediterr Health J. 2011 Jul;17(7):611-8
references: 21972486
references: Chest. 2007 Apr;131(4):1133-41
references: 17426220
references: Tuber Lung Dis. 1997;78(1):29-34
references: 9666960
references: Int J Tuberc Lung Dis. 2003 Aug;7(8):777-86
references: 12921155
references: Chest. 1991 Jun;99(6):1555-6
references: 2036863
references: Int J Tuberc Lung Dis. 2009 Feb;13(2):214-20
references: 19146750
references: Exp Cell Res. 1980 Oct;129(2):281-7
references: 7428821
references: Thorax. 1995 Jun;50(6):600-3
references: 7638798
references: Eur Respir J. 2008 May;31(5):1098-106
references: 18448504
references: Respir Med. 2001 Jul;95(7):577-81
references: 11453314
references: J Interferon Cytokine Res. 2004 Apr;24(4):213-7
references: 15144567
references: Eur Respir J. 1996 Dec;9(12):2635-9
references: 8980981
references: Chest. 1990 Jun;97(6):1381-5
references: 1971783
references: Acta Med Scand. 1984;215(4):299-304
references: 6731043
references: Respir Med. 2003 Dec;97(12):1289-95
references: 14682409
references: J Physiol Pharmacol. 2008 Dec;59 Suppl 6:349-60
references: 19218659
references: Eur Respir J. 1996 Apr;9(4):747-51
references: 8726940
references: Chest. 1990 Mar;97(3):605-10
references: 1689629
references: Br Med J. 1978 Dec 23-30;2(6154):1751-2
references: 737480
references: Respir Med. 1994 Feb;88(2):139-43
references: 8146413
references: Thorax. 1999 Oct;54(10):921-4
references: 10491456
references: Chest. 1988 Feb;93(2):308-11
references: 3123150
references: Am J Med. 2003 Oct 1;115(5):365-70
references: 14553871
references: J Clin Lab Anal. 1999;13(5):209-12
references: 10494128
references: J Lab Clin Med. 1996 Apr;127(4):326-7
references: 8656033
references: Ann Clin Biochem. 2003 Jul;40(Pt 4):374-81
references: 12880538
references: Respir Med. 2008 May;102(5):744-54
references: 18222681
references: Chest. 2004 Mar;125(3):987-9
references: 15006958