A Case of Tuberculous Pericarditis Diagnosed by Increased ADA Activity in Pericardial Fluid

ABSTRACT

There is no diagnostic study for the presence of tuberculous pericarditis that is highly accurate as well as safe and easy to perform. As a result, the diagnosis is often delayed or missed, resulting in a clinical course characterized by increased mortality and late complications. Adenosine deaminase (ADA) in pleural or pericardial fluid is known for a useful marker of extrapulmonary tuberculosis. A 76-year old woman visited for dyspnea and generalized edema. Culture for sputum, pleural fluid, and pericardial fluid were negative for tubercle bacillus. But We diagnosed tuberculous pericarditis with pleuritis by increased titer of ADA activity in the pericardial fluid. After 2 weeks of initiation of antituberculous treatment, pericardial and pleural effusion gradually decreased while clinical symptoms improved markedly. Therefore, authors report a case of tuberculous pericarditis diagnosed by increased ADA activity in pericardial fluid with reviewing the previous literatures.