Biochemical markers in patients with tuberculous pleural effusion

ABSTRACT

To compare the diagnostic efficiency of adenosine deaminase, isoenzyme adenosine deaminase-2 and concentration of interferon- gamma in patients with tuberculous pleural effusion. The prospective study was done on 103 patients who were divided into 3 groups tuberculous, non-tuberculous infectious pleurisy, and malignant effusion. The adenosine deaminase, adenosine deaminase-2 and interferon- gamma were analyzed by receiver operating characteristic curves. There was increase of all three markers in tuberculous pleural effusion but not in nontuberculous effusion. The cut-off values for adenosine deaminase, adenosine deaminase-2 and interferon- gamma were 40, 26 U/l. and 299 pg/ml respectively. Adenosine deaminase, adenosine deaminase-2 activities were significantly higher in tuberculous effusion than in malignant pleural effusion [more than 5 times] and in non-tuberculous infectious pleurisy [more than 4 times]. The median of interferon- gamma concentration in pleural fluid of tuberculous patients was 1514.2 pg/ml [931.2-2187.5pg/ml] which was 10 times more than the median values of other groups of patients. There was no significant difference between patients with malignant effusion and those with non-tuberculous effusion. All three markers had higher diagnostic yield for tuberculous effusion