DOI: 10.36347/sjams.2017.v05i04.051

Pages: 1492-1494

The objective is to determine the importance of adenosine deaminase (ADA) in exudative pleural effusions of different etiologies. It was an observational study conducted at a tertiary care teaching institute. Out of a total of 50 pleural fluid samples, 35 were found to be exudates and were include in the study. Pleural fluid ADA was done for all included patients. Pleural fluid ADA ≥40 U/l was taken as diagnostic cut off for TB effusion. Sensitivity, specificity positive and negative predictive value of pleural fluid ADA for diagnosing TB was calculated by using clinical calculator – 1, Richard Lowry 2001-2013. There were 35 patients with pleural effusion, out of which 35 (71.8%) were found to be exudative and were studied further. There were 17 (40.1%), 6 (29.5%) and 7(27%) cases of TB, malignancy and para pneumonic effusion respectively, whereas 5(3.3%) cases remained undiagnosed. Median ADA values for TB, malignancy and para pneumonic effusion were 49.8 U/l, 18 U/l and 25 U/l respectively. Conclusion: Pleural fluid ADA remains useful in diagnosing tuberculosis pleural effusion. The median ADA for TB effusion in present cohort was 49.8 IU/ml. Pleural fluid ADA of 40 U/L yielded 89.5% negative predictive value and 75% positive predictive value. Pleural fluid ADA is cost effective and good screening test for diagnosis of TB.