To study the combined use of pleural fluid lymphocyte/ neutrophil ratio and ADA for the diagnosis of tuberculous pleural effusion

Background: Pulmonary tuberculosis is the most frequent cause of death by an infectious agent worldwide. Among the extra pulmonary presentations after tuberculous lymphadenitis, pleural TB is the second most frequent Failure to diagnose and treat pleural TB can result in progressive disease with the involvement of other organs in as many as 65% of patients. Conventional methods have proven to be insufficient for diagnosis of pleural TB. Hence, this study was aimed to determine whether combined use of pleural fluid lymphocyte neutrophil ratio and ADA activity would provide a more efficient means for diagnosing tuberculous pleurisy than the use of ADA levels. Aim: To determine whether the combined use of ADA activity and lymphocyte/neutrophil ratio would provide a more efficient means for diagnosing tuberculous pleural effusion than with the use of ADA alone. Materials and methods: Present study was hospital based prospective observational study carried out from February 2016 to July 2016. All the patients with pleural effusion admitted in medical ward at GRH Madurai. Information collected through preformed and pretested proforma. The qualifying patients were undergoing detail history, clinical examination and investigation. Patients were classified as exudative and transudative pleural effusion based on light's criteria Patients with MRS score of 5 and 6 were declared as very poor outcome and MRS of 3 and 4 as poor outcome. Patients with MRS 0, and 1 were considered as good outcome. Statistical analysis was done by One way ANOVA, Pearson correlation and Chi square test. Results: There was significant correlation between the combined use of ADA along with L/N ratio than ADA alone for diagnosing tuberculous Pleural effusion. Conclusions: The combined use of ADA along with L/N ratio would provide a more efficient means for diagnosing tuberculous Pleural effusion than the use of ADA alone.