Diagnostic value of Adenosine Deaminase (ADA) Activity inTubercular Serositis.

ABSTRACT

Background: Adenosine deaminase has been proposed to be a useful surrogate marker for tuberculosis in pleural, pericardial and peritoneal fluids. Studies have confirmed high sensitivity and specificity of Adenosine deaminase for early diagnosis of extra pulmonary tuberculosis. Aim: To assess the diagnostic level of ADA in tubercular serosal effusion and to determine its sensitivity and specificity. Methods: The study was carried out on 120 patients suffering from serosal effusion (50 pleural, 50 peritoneal, and 20 cases of pericardial effusion) . Detailed clinical history, physical examination and routine and relevant investigation of all patients including ADA estimation by GALANTI AND GIUSTI method was done. Results: ADA Level in tuberculous pleural effusion ranged from 45-160 U/L with a mean level of 100U/L and sensitivity and specificity of 100% (p<0.001, highly significant). ADA level in tuberculous peritoneal effusion ranged from 35-135 U/L with a mean level of 92U/L and sensitivity and specificity of 100% and 95% respectively (p<0.001, highly significant). ADA level in tubercular pericardial effusion ranged from 63-117 U/L with a mean level of 90U/L and sensitivity and specificity of 100% and 83.3% respectively (p<0.005, very significant).In toto serosal fluid ADA level estimation offers high degree of sensitivity and specificity of about 100% and 94.6% respectively, Conclusion: ADA was found positive with a mean value of 100U/L, 92U/L and 90 U/L in tubercular pleural, peritoneal and pericardial effusion respectively with overall 100% sensitivity and 94.6% specificity and cutoff value of 40 U/L.