ABSTRACT
Increased serum adenosine deaminase [ADA] activity, mainly associated with tuberculosis can also occur in a number of other diseases thus negatively affecting the diagnostic utility of ADA measurements in tuberculosis. The aim of the study was to determine whether or not the combined use of the activity of ADA, its isoenzymes and differential cell counts would provide a more efficient means of diagnosing tuberculosis than the use of ADA levels alone. Design: A prospective case-control study. Place and Duration of Study: Department of Biochemistry, King Saud University, Riyadh, Kingdom of Saudi Arabia. Duration was 3 years [2000-2003]. Subjects and Fifty healthy individuals and fifty clinically diagnosed for pulmonary tuberculosis patients were included in this study. Nine measurements of several variables including serum ADA, ADA1, ADA2, ratios of ADA1/ADA, ADA2/ADA, total and differential cell counts were carried out at different periods of time during 6 months of follow up. Data suggested significant [p<0.05] increase in serum ADA and ADA-2 values, which decreased [p<0.05] during the first 2 months in the patients as a whole, followed by stabilization of ADA activity. This decline was mainly due to marked decrease [p<0.05] in ADA2. The ratio [>0.75] of ADA2/ADA was found to be better indicator of tuberculosis. Lymphocyte neutrophil ratio [L/N] > 0.69 gave additional benefit to increase the sensitivity and specificity for the use of ADA as marker in diagnosing tuberculosis. The combined use of activity of ADA, its isoenzymes and total and differential cell counts is a better indicator and gives better understanding to diagnose and evaluate tuberculosis and response to therapy
Subject(s)
Humans , Tuberculosis/enzymology , Tuberculosis/drug therapy , Tuberculosis/diagnosis , Isoenzymes , Leukocyte CountABSTRACT
Serum adenosine deaminase (ADA) levels reflect activity of stimulated T lymphocytes and its levels are raised whenever cell mediated immunity is stimulated. One hundred term normal newborns were studied to evaluate effect of BCG vaccination on serum ADA levels. Serum ADA was measured at birth and 6 weeks after BCG vaccination. Only 67 subjects came for follow up after 6 weeks. The levels were 6.69 U/litre at birth and 13.83 U/litre after 6 weeks of vaccination showing a significant rise. It is concluded that serum ADA levels can be used as a measure of cell mediated immunity after BCG vaccination.
Subject(s)
Adenosine Deaminase/blood , BCG Vaccine/administration & dosage , Case-Control Studies , Developing Countries , Evaluation Studies as Topic , Female , Humans , India , Infant, Newborn , Male , Reference Values , Tuberculosis/enzymology , VaccinationABSTRACT
A atividade da adenosina deaminase (ADA) foi estudada em 108 pacientes com derrames pleurais de etiologias variadas, com o objetivo de avaliar seu valor diagnóstico. Os pacientes foram submetidos à punçäo biópsia pleural e análise bioquímica, citológica e bacteriológica do líquido. A atividade da ADA foi realizada em todos os casos. Os resultados obtidos foram divididos em grupos, segundo a etiologia do derrame. Os resultados demonstraram que os grupos tuberculose, provável tuberculose e empiema apresentaram atividade da ADA superior aos demais grupos, permitindo sugerir que se trata de método que deve ser incluído como exame de rotina no diagnóstico dos derrames pleurais