title: Evaluation of adenosine deaminase activity for the diagnosis of pleural TB in lymphocytic pleural effusions.
abstract: OBJECTIVE
  To evaluate the diagnostic value of pleural adenosine deaminase (P-ADA) as a pleural TB-specific biomarker in lymphocytic pleural effusions.
  
  
  METHODS
  Pleural effusions were classified on the basis of definitive diagnosis.
  
  
  RESULTS
  A total of 218 patients (122 tuberculous and 96 nontuberculous) were included in the study. The optimal cut-off value of P-ADA (receiver operating characteristic curve) for the diagnosis of pleural TB was 40.0 U/l (Giusti method). In lymphocytic pleural effusions P-ADA had a sensitivity of 80.3%, a specificity of 96.0% and an accuracy of 86.2%. The positive predictive value was 97.0% and the negative predictive value was 75.0%. The positive likelihood ratio and negative likelihood ratio were 19.8 and 0.2, respectively (p < 0.0001).
  
  
  CONCLUSIONS
  P-ADA activity is recommended for the diagnosis of TB in lymphocytic pleural effusions.
authors: Departamento de Medicina Clínica da Faculdade de Medicina da Universidade Federal Fluminense, Rio de Janeiro, Brazil. ctsilvajunior@predialnet.com.br
authors: Cyro Teixeira
authors: CT
authors: da Silva
authors: Rodolfo Fred
authors: RF
authors: Behrsin
authors: Gilberto Perez
authors: GP
authors: Cardoso
authors: Elizabeth Giestal
authors: EG
authors: de Araújo
mesh_terms: D000243:Adenosine Deaminase / Q000032:analysis*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000175:diagnosis*; D011237:Predictive Value of Tests; D014396:Tuberculosis, Pleural / Q000175:diagnosis*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D000243:Adenosine Deaminase