scholarly journals P6‐23: Diagnostic utility of adenosine deaminase (ADA) activity in pleural fluid and pleural fluid lactate dehydrogenase/ADA ratio of tuberculous and non‐tuberculous pleural disease

Respirology ◽  
2021 ◽  
Vol 26 (S3) ◽  
pp. 234-234
Keyword(s):  
Lactate Dehydrogenase ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Diagnostic Utility ◽  
Pleural Disease

The Utility of Pleural Fluid Lactate Dehydrogenase to Adenosine Deaminase Ratio in Pleural Tuberculosis

Respiration ◽  
2020 ◽  
pp. 1-5
Author(s):  
Amanda Beukes ◽  
Jane Alexandra Shaw ◽  
Andreas H. Diacon ◽  
Elvis M. Irusen ◽  
Coenraad F.N. Koegelenberg
Keyword(s):  
Lactate Dehydrogenase ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Operating Characteristic ◽  
Retrospective Studies ◽  
Characteristic Curve ◽  
Diagnostic Efficiency ◽  
Pleural Tuberculosis ◽  
High Incidence ◽  
The Mean

In high-burden settings, the diagnosis of pleural tuberculosis (TB) is frequently inferred in patients who present with lymphocyte predominant exudative effusions and high adenosine deaminase (ADA) levels. Two recent small retrospective studies suggested that the lactate dehydrogenase (LDH)/ADA ratio is significantly lower in TB than in non-TB pleural effusions and that the LDH/ADA ratio may be useful in differentiating pleural TB from other pleural exudates. We compared the pleural LDH/ADA ratios, ADA levels, and lymphocyte predominance of a prospectively collected cohort of patients with proven pleural TB (<i>n</i> = 160) to those with a definitive alternative diagnosis (<i>n</i> = 68). The mean pleural fluid LDH/ADA ratio was lower in patients with pleural TB than alternative diagnoses (6.2 vs. 34.3, <i>p</i> &#x3c; 0.001). The area under the receiver operating characteristic curve was 0.92 (<i>p</i> &#x3c; 0.001) for LDH/ADA ratio and 0.88 (<i>p</i> &#x3c; 0.001) for an ADA ≥40 U/L alone. A ratio of ≤12.5 had the best overall diagnostic efficiency, while a ratio of ≤10 had a specificity of 90% and a positive predictive value of 95%, with a sensitivity of 78%, making it a clinically useful “rule in” value for pleural TB in high incidence settings. When comparing the LDH/ADA ratio to an ADA level ≥40 U/L in the presence of a lymphocyte predominant effusion, the latter performed better. When lymphocyte values are unavailable, our data suggest that the LDH/ADA ratio is valuable in distinguishing TB effusions from other pleural exudates.

The utility of pleural fluid lactate dehydrogenase to adenosine deaminase ratio in pleural tuberculosis

2020 ◽  
Author(s):  
Amanda Beukes ◽  
Jane Alexandra Shaw ◽  
Elvis M Irusen ◽  
Andreas H Diacon ◽  
Coenraad Frederik Nicolaas Koegelenberg
Keyword(s):  
Lactate Dehydrogenase ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Pleural Tuberculosis

The comparative value of pleural fluid adenosine deaminase and neopterin levels in diagnostic utility of pleural tuberculosis

2015 ◽  
Vol 63 (4) ◽  
pp. 243-249 ◽  
Author(s):  
Filiz KOŞAR ◽  
Sibel YURT ◽  
Burcu ARPİNAR YİĞİTBAŞ ◽  
Barış ŞEKER ◽  
Hatice KUTBAY ÖZÇELİK ◽  
...  
Keyword(s):  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Diagnostic Utility ◽  
Pleural Tuberculosis
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