Clinical utility of interferon-gamma compared to ADA in tuberculous pleural effusion

Tuberculosis [TB], the single most frequent infectious cause of death worldwide, also is a major cause of pleural effusion, which in TB usually has lymphocytic and exudative characteristics. Differential diagnosis between TB and nontuberculous pleural effusion can be sometimes difficult, representing a critically important clinical problem. To evaluate the clinical utility of pleural IFN-gamma level in pleural fluid for diagnosing tuberculous pleuritis. The study was conducted in kasr El-Aini hospital, Cairo University in the period from January 2011 to January 2012. It was carried on 40 patients. The patients included in the study were classified into group I [included 20 cases with tuberculous pleural effusion] and group II [included 20 cases with non tuberculous pleural effusion]. All patients were subjected for complete history taking and clinical examination, chest X-rays PA and lateral views, pleural fluid aspiration and analysis. Our results demonstrate that the pleural fluid concentrations of ADA, INF-gamma in patients with tuberculous pleural effusions are significantly higher than in other effusions. Most importantly, ROC analysis clearly demonstrated ADA to be more sensitive and specific than INF-gamma for diagnosis of tuberculous pleuritis

Diagnostic value of adenosine deaminase in tuberculous and malignant pleural effusion

Tuberculous pleural effusion [TPE] is a common problem for differential diagnosis from malignant effusion [MPE] in epidemic areas of tuberculosis [TB]. Prediction based on adenosine deaminase [ADA] is dependent on age as well as the tuberculosis incidence. To estimate the value of cutoff point of ADA in MPE and TPE and to evaluate its role in differential diagnosis in Egypt a country with high incidence of TB. The study was conducted in Kaser El-Aini Hospital, Cairo University in the period from April 2011 to January 2012. It was carried on 30 patients. We retrospectively analyzed 30 patients with a definitive diagnosis of TPE [n= 19] and MPE [n= 11]. The optimal cutoff value of ADA was determined using the receiver operating characteristic [ROC] curve. There was a statistically significant difference according to the levels of pleural fluid ADA between TPE and MPE groups. Confirm that ADA is a very useful parameter for the differential diagnosis of TPE and MPE, specifically in younger with a higher incidence of tuberculosis