title: Diagnostic value of sputum adenosine deaminase (ADA) level in pulmonary tuberculosis.
abstract: BACKGROUND
  Tuberculosis is still a considerable health problem in many countries. Rapid diagnosis of this disease is important, and adenosine deaminase (ADA) has been used as a diagnostic test. The aim of this study was to assess the diagnostic value of ADA in the sputum of patients with pulmonary tuberculosis.
  
  
  METHODS
  The current study included 40 patients with pulmonary tuberculosis (culture positive, smear ±) and 42 patients with non tuberculosis pulmonary diseases (culture negative). ADA was measured on all of the samples.
  
  
  RESULTS
  The median value of ADA in non-tuberculosis patients was 2.94 (4.2) U/L and 4.01 (6.54) U/L in tuberculosis patients, but this difference was not statistically significant (p=0.100). The cut-off point of 3.1 U/L had a sensitivity of 61% and a specificity of 53%, the cut-off point of 2.81 U/L had a sensitivity of 64% and a specificity of 50% and the cut-off point of 2.78 U/L had a sensitivity of 65% and a specificity of 48%. The positive predictive values for cut-off points of 3.1, 2.81 and 2.78 U/L were 55.7%, 57.44% and 69.23%, respectively. The negative predictive values for the abovementioned cut-off points were 56.75%, 57.14% and 55.88%, respectively.
  
  
  CONCLUSIONS
  Our results showed that sputum ADA test is neither specific nor sensitive. Because of its low sensitivity and specificity, determination of sputum ADA for the diagnosis of pulmonary tuberculosis is not recommended.
authors.affiliation: MD, Department of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Fariba
authors.initials: F
authors.lastname: Binesh
authors.affiliation: MD, Resident of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Hadi
authors.initials: H
authors.lastname: Jalali
authors.affiliation: Bs, Nikoopoor Health Center, Yazd, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Zare
authors.affiliation: Bs, Central Laboratory, Yazd, Iran.
authors.forename: Farhad
authors.initials: F
authors.lastname: Behravan
authors.affiliation: Ms, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Arefeh Dehghani
authors.initials: AD
authors.lastname: Tafti
authors.affiliation: MD, Department of Infectious Diseases, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Fatemah
authors.initials: F
authors.lastname: Behnaz
authors.affiliation: Bs, Nikoopoor Health Center, Yazd, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Tabatabaee
authors.affiliation: Ms, Infectious Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Seyed Hossein
authors.initials: SH
authors.lastname: Shahcheraghi
keywords: ADA; Tuberculosis; diagnosis; sputum