Adenosine Deaminase as a Biomarker for the Diagnosis of Tubercular Pleural Effusion

ABSTRACT

Background:The aim of our study was to study and compare the levels of Adenosine deaminase, total proteins and glucose levels in tubercular and non tubercular Pleural Effusion patients, and simultaneously to establish the diagnostic utility of Pleural fluid adenosine deaminase activity in tubercular pleural effusion. Study Design: A hospital based cross sectional study was conducted on patients attending the Out Patient Department or admitted in Medicine or Pulmonary Ward of SMIH, Dehradun (UK) for a period of 6 months from Aug2017 to Jan 2018. 56 cases of tubercular pleural effusion above 15years were selected randomly for the study. The control group consists of 54 subjects of non tubercular pleural effusion. Exclusion criteria was age below 14 years & those who were not willing to participate. Inclusion criteria was age above 14 years, Pleural fluid smear positive for AFB or fluid culture positive for mycobacteria tuberculosis, positive sputum culture, positive pleural biopsy. All the cases and controls were subjected to complete history, clinical examination and pleural fluid estimation for ADA, protein and glucose. Material & Method: Both the cases and controls were subjected to complete history taking, clinical examination and pleural fluid estimation for ADA, protein and glucose. The pleural fluid sample was processed on Vitros 250 for glucose & protein and on semi autoanalyzer (Erba chem) for ADA.Results & Conclusion: In the test group the Mean ± SD of ADA activity was 103.29±61.26 IU/l whereas in control group it was25.0±18.2 IU/l. Thus the activity of ADA in the test group was significantly higher than the control group (p<0.0001). In the test group, the Mean ± SD of glucose level was 65.80±29.27 mg/dl and in the control group was 123.1±79.9 mg/dl. Thus the level of glucose in the control group was higher than the test group (p<0.0001). Similarly the mean values of protein were found to be much higher in test group (4.69±0.97 gm/dl) as compared to the control group (3.2±1.0 gm/dl), which was found to be highly significant (p<0.001).