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Role of adenosine deaminase in diagnosis of exudative type of pleural effusion

R S Pushpa Kumari, B L Narsimha Reddy, V A Vipula.




Abstract

Background: The diagnosis of tubercular pleural effusion remains a common clinical challenge. At least 50% of cases of tubercular pleural effusion present as primary disease without involvement of other organs.

Objectives: Estimation and comparison of Adenosine Deaminase (ADA) levels in exudative pleural effusions with special reference to tubercular aetiology.

Materials and Methods: Sixty patients of pleural effusions of various aetiologies formed the sample of the study. Pleural fluid analysis was done and clinical profile of each patient was taken. Total patients were divided into 6 groups consists of Tubercular pleural effusion (39), parapneumonic effusion (10), emphyema (5), malignant pleural effusion (3), pancreatic pleural effusion (2) and amoebic pleural effusion (1).

Results: Incidence of tubercular pleural effusion is 65% followed by parapneumonic effusions 16.6%. Males (68.3%) are more prone to incidence of tubercular pleural effusion.

Conclusion: Pleural fluid Adenosine deaminase (ADA levels are highly sensitive for tuberculous pleural effusions. ADA is diagnostic even in HIV positive patients with tubercular pleural effusion. ADA levels easily differentiate tuberculous pleural effusion from parapneumonic, malignant, pancreatic, and amoebic pleural effusions.

Key words: Adenosine Deaminase (ADA), Tubercular pleural effusion, Para pneumonic effusion, Empyema






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