DOI: 10.36347/sjams.2018.v06i07.001

Pages: 2609-2614

Exudative pleural effusions are a common diagnostic problem in clinical practice, as the list of causes is quite exhaustive, although sometimes they can be inferred from the clinical picture. Exudative effusions require to be separated into infectious causes, noninfectious causes and malignancy. The most common causes in most series are infections and malignancy. Tuberculosis was found to be the most common cause (74%) of pleural effusion in the region followed by malignancy (18%). Aims and objectives were Evaluate the role of ADA in diagnosis of exudative pleural effusion and Evaluate the role of cytology in diagnosis of exudative pleural effusion. This prospective study was carried out on 100 consecutive patients with exudative pleural effusions in the Department of Respiratory Medicine, Govt. Medical College and hospital Kota Over the period of October 2012 to September 2013. On the basis of history, clinical examination and various investigation with inclusion & exclusion criteria the study population finally divided into either tuberculous or non- tuberculous group. Statistical analysis was performed using a two way (time and group) analysis of variance followed by student‘t’ test for parametric data. On comparison of the result of various tests and their combinations in our study, ADA emerged as a single best diagnostic test with sensitivity of 89.18%. The specificity can be increased from 84.62% with ADA alone to a good 96.15% by combining ADA and lymphocytes proportion of >50% in pleural fluid as a diagnostic criteria in tuberculous pleural effusions. However if ADA is between 40-63U/L it is highly suspicious of Tuberculous pleural effusion, and then the cytology report will aid in confirming the diagnosis. A lymphocyte exudates (50%) with high ADA value (40U/L) is highly suggestive of tuberculous pleural effusion.