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

ABSTRACT

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