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Research Paper | Biochemistry | India | Volume 12 Issue 2, February 2023

Diagnostic Accuracy of Ada at Various Cut off Limit in Tubercular Pleural Effusion

Dr. Shubhra Tiwari | Dr. Rakhi Negi | Dr. Pratibha Misra | Dr. Arpitha | Dr. Prashant Patil

Abstract: Background: Tuberculosis (TB), is a bacterial disease caused by Mycobacterium tuberculosis. The spectrum of extrapulmonary TB (EPTB) includes pleural fluid, ascitic fluid, intestine, spine etc. Diagnosis of TB can be done using Ziehl - Neelsen (ZN) staining and Polymerase Chain Reaction (PCR), but these methods do not have enough sensitivity and specificity. The gold standard test for diagnosing TB is mycobacterium culture, but it takes six weeks to isolate which can lead to a delay in diagnosis. Estimating Adenosine deaminase (ADA) is a simple, low - cost, quick aid for diagnosing tubercular pleural effusion. Methodology: We measured ADA in pleural fluid in 60 patients in a tertiary care hospital by using a Robonik biochemistry semi - auto analyser. Other investigations like - ZN staining, culture, and cytological analysis are also performed on patients. A cross - sectional study is done to know the sensitivity and specificity of ADA at various cut off ranging from <40, 40 - 60, 60 - 80 and >80IU/L in diagnosing tubercular pleural effusion. Also, correlation is done with predominant leucocyte count and LDH/ADA ratio. Results: Pleural fluid ADA level <40 IU/L has a high sensitivity for ruling out the disease. Sensitivity and specificity are found to moderate in the range of 40 - 80IU/L and high at the ADA level of >80 IU/L. Conclusion: Though ADA is an established marker for the diagnosis of tubercular pleural effusion, the cut - off with high sensitivity and specificity remains unclear. So, we aim to study the sensitivity and specificity of ADA at various cut - off levels and the utility of the LDH/ADA ratio in the diagnosis of tubercular pleural effusion.

Keywords: ADA, tubercular pleural effusion, sensitivity and specificity

Edition: Volume 12 Issue 2, February 2023,

Pages: 337 - 340

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