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Original Research | Pathology | Volume 15 Issue 8, August 2026 | Pages: 101 - 106 | India
Diagnostic Utility of Combined Pleural Fluid Adenosine Deaminase Activity and Lymphocyte Proportion in Tuberculous Pleural Effusion: A Prospective Observational Study
Abstract: Background: Tuberculous pleural effusion (TPE) is a common form of extrapulmonary tuberculosis. Although pleural fluid adenosine deaminase (ADA) is widely used for diagnosis, combining ADA with lymphocyte predominance may improve diagnostic accuracy. This study evaluated the diagnostic utility of combined pleural fluid ADA activity and lymphocyte proportion in TPE. Methods: This prospective observational study included 117 patients with pleural effusion. Pleural fluid ADA levels and differential leukocyte counts were analyzed. Tuberculous and non-tuberculous pleural effusions were compared, and diagnostic performance was assessed using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results: Eighty-two patients (70.1%) had tuberculous pleural effusion. ADA >40 IU/L showed 92.68% sensitivity and 80.00% specificity. Lymphocyte proportion >50% demonstrated 91.46% sensitivity and 82.86% specificity. The combined use of both parameters increased specificity to 97.14% and PPV to 98.61%, thereby improving diagnostic confidence. Conclusion: Combined pleural fluid ADA activity and lymphocyte predominance provide a simple, inexpensive, and highly specific diagnostic approach for tuberculous pleural effusion, particularly in resource-limited settings.
Keywords: Tuberculous pleural effusion, Adenosine deaminase, Pleural fluid, Lymphocyte proportion, Extrapulmonary tuberculosis, Diagnostic accuracy
How to Cite?: Dr. Utkarsha Gera, Dr. Chetna Jain, "Diagnostic Utility of Combined Pleural Fluid Adenosine Deaminase Activity and Lymphocyte Proportion in Tuberculous Pleural Effusion: A Prospective Observational Study", Volume 15 Issue 8, August 2026, International Journal of Science and Research (IJSR), Pages: 101-106, https://www.ijsr.net/getabstract.php?paperid=MR26731110038, DOI: https://dx.doi.org/10.21275/MR26731110038