Usefulness of the Pleural Fluid Adenosine Deaminase with Lymphocyte/Neutrophil Ratio in the Diagnosis of Tuberculous Pleurisy for a Region of Intermediate Prevalence of Tuberculosis / 결핵및호흡기질환
Tuberculosis and Respiratory Diseases
;
: 437-443, 2009.
Artigo
em Inglês
| WPRIM
| ID: wpr-73518
ABSTRACT
BACKGROUND:
The aim of this study was to consider the significance of pleural fluid adenosine deaminase (ADA) activity combined with lymphocyte/neutrophil (L/N) ratio in the diagnosis of tuberculous pleurisy (TBpl) in a region of intermediate prevalence of tuberculosis (TB).METHODS:
We collected data from 388 patients with exudative pleural effusions. The final diagnoses were compared to the results from our diagnostic method using pleural fluid ADA and L/N ratio.RESULTS:
108 patients had a final diagnosis of TBpl; 102 cases had high levels of ADA (> or =40 IU/L). When we considered ADA > or =40 IU/L as a diagnostic criterion, the sensitivity was 94.4%, specificity 87.5%, and post-test probability 74.5%. However, when we considered ADA > or =40 IU/L combined with the L/N ratio > or =0.75 as a diagnostic criterion, the specificity and post-test probability were rose to 97.5% and 93%, respectively. The other causes of high ADA and L/N ratios were lymphoma and metastatic carcinoma, but mass-like lesions were found on the chest radiographs or CT scans.CONCLUSION:
To evaluate the causes of exudative pleural effusions in a region of intermediate prevalence of tuberculosis, we recommend measuring the pleural fluid ADA and L/N ratio first. If the result is high and malignancies are not suspected, it may be diagnostic of TBpl.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Derrame Pleural
/
Tórax
/
Tuberculose
/
Tuberculose Pleural
/
Adenosina
/
Adenosina Desaminase
/
Prevalência
/
Linfoma
Tipo de estudo:
Estudo diagnóstico
/
Estudo de prevalência
Limite:
Humanos
Idioma:
Inglês
Revista:
Tuberculosis and Respiratory Diseases
Ano de publicação:
2009
Tipo de documento:
Artigo
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