Evaluation of Pleural Fluid Adenosine Deaminase Activity in Tubercular Pleural Effusion in a Military Hospital

  • Md Kabir Uddin Assistant Professor of Medicine and Respiratory Medicine, CMH Dhaka
  • Md Abdul Ali Mia Consultant Physician General, Bangladesh Armed Forces, Dhaka
  • Mamun Mostafi Chief Physician, CMH Dhaka
  • Mimi Parvin Classified Spl in Pathology, AFIP, Dhaka
  • Mainul Ahmed Chowdhury MD(Med), Classified Spl in Medicine, CMH Dhaka
Keywords: Adenine deaminase (ADA), Tubercular pleural effusion (TPE), Malignant pleural effusion (MPE).

Abstract

Introduction: Tubercular pleural effusion (TPE) is one of the common extra pulmonary tuberculosis which many a times become difficult to make definite diagnosis on account of low sensitivity and/or specificity of non-invasive diagnostic tools. Even pleural biopsy cannot establish all the diagnosis; rather after patient shows unwillingness to invasive procedure. A reliable sensitive and specific marker is required for early diagnosis of TPE as Bangladesh is a high Tuberculosis burden country. Adenine deaminase (ADA) may be a useful surrogate marker.

Objective: To find out a reliable sensitive and specific marker for early diagnosis of TPE as Bangladesh is a high Tuberculosis burden country.

Materials and Methods: This study carried out ADA estimations in 170 cases of pleural effusion at Combined Military Hospital (CMH) Dhaka. Efforts were made to reach diagnosis by other means.

Results: ADA level was found in tubercular pleural effusion ranges from 25 to 180 with a mean 71.51 ±33.1. It ranges 3 U/L to 170U/L with non-tubercular effusion with a mean 20.96±16.71. The sensitivity of ADA is 90.9% and specificity is 95.7% in diagnosing TPE. The positive and negative predictive values are 90.91 % and 95.65% respectively.

Conclusion: ADA is found cheap, sensitive and a useful surrogate marker. However, it is not a confirmatory diagnostic tool but can be used as a reliable adjunct to other investigations.

Journal of Armed Forces Medical College Bangladesh Vol.11(2) 2015: 69-75

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Author Biography

Md Kabir Uddin, Assistant Professor of Medicine and Respiratory Medicine, CMH Dhaka

Dept. of Medicine and Respiratory Medicine

Published
2019-01-16
How to Cite
Uddin, M. K., Mia, M. A., Mostafi, M., Parvin, M., & Chowdhury, M. (2019). Evaluation of Pleural Fluid Adenosine Deaminase Activity in Tubercular Pleural Effusion in a Military Hospital. Journal of Armed Forces Medical College, Bangladesh, 11(2), 69-75. https://doi.org/10.3329/jafmc.v11i2.39826
Section
Original Papers