ADENOSINE DEAMINASE ANALYSIS IN TUBERCULOUS PLEURAL EFFUSION

Tuberculosis is a major cause of pleural effusion, in which pleural fluid usually has lymphocytic and exudative characteristic. Accurate and early diagnosis of tuberculous pleurisy is essential for its correct treatment and management in clinical practice. Adenosine Deaminase is an enzyme that increases in Tuberculosis (TB) because of the stimulation of T cell lymphocytes by mycobacterial antigens. The current methods for the diagnosis of Tuberculosis do not provide enough sensitivity and specificity.Aims and objectives-Aim of the study is to evaluate the ADA activity in patients with tuberculous pleural effusion and transudative pleural effusion and to find out the diagnostic role in tuberculous pleurisy. Materials and Methods-One hundred cases admitted in the medical ward on account of pleural effusion were selected.As per Lights criteria cases are classified in to exudate and transudate. The final diagnosis was based on standard diagnostic criteria. For TB pleural effusion, the following criteria was adapted ctice. to label as a case of Tuberculous effusion. 1. Bacteriological confirmation of presence of Mycobacterium tuberculosis. (direct smear or culture). 2. Radiological finding consistent with tuberculosis exclusion of other clinical consideration. 3. Clinical presentation consistent with tuberculosis (with exclusion). Group I includes 50 cases of Tuberculous pleural effusion and Group II includes 50 cases of transudative pleural effusion.ADA was estimated in pleural fluid in both the groups. ADA activity was measured in pleural fluid by the Guisti and Glanti s method using semi autoanalyser.Results- The mean and standard deviation of ADA level in pleural fluid was significantly high in group I (102.86 plus or minus 22.61) when compared to group II (16.48 plus or minus 3.02) and the p value was statistically significant. Conclusion- Our study supports the view that pleural fluid ADA estimation is a very useful biomarker in establishing an accurate diagnosis in tuberculous pleural effusion. In addition it is a simple, rapid and an inexpensive investigation that could be a complimentary test in the diagnostic workup of tuberculous pleurisy in clinical pra