Role of pleural fluid adenosine deaminase in aetiological diagnosis of pleural effusion

10.5580/1a8c ◽  
2009 ◽  
Vol 7 (1) ◽  
Author(s):  
SuchitaDilip Modi ◽  
AnilKalyandas Agrawal ◽  
ArvindS Bhake ◽  
VikasR Agrawal

2016 ◽  
Vol 33 (3) ◽  
pp. 159 ◽  
Author(s):  
Biswajit Biswas ◽  
SudershanKumar Sharma ◽  
RameshwarSingh Negi ◽  
Neelam Gupta ◽  
VirenderMohan Singh Jaswal ◽  
...  

Author(s):  
Praveen Radhakrishnan ◽  
S Mathanraj

Introduction: Pleural effusions, the result of the accumulation of fluid in the pleural space, are a major diagnostic problem due to its anatomical nature with no direct access. There is variation in management, depending on the pleural disease. The pleural effusion can either exhibit specific or nonspecific characteristics. Aim: To determine the clinical significance and diagnostic role of pleural fluid C-Reactive Protein (CRP) level in the aetiological diagnosis of exudative pleural effusion. Materials and Methods: This was a cross-sectional study performed during the study period of September 2013 to December 2014. A total of 53 Patients identified with pleural effusion were recruited in the study and pleural fluid was subjected for the measurement of CRP level. Pleural fluid CRP was assessed with CRP-Turbilatex-Quantitative turbidimetric immunoassay method which is based on the principle agglutination reaction. The data was subjected to statistical analysis using Epi info software version 3.4.3. The Receiver Operating Characteristic (ROC) curve was plotted to illustrate the diagnostic ability. The smallest cut-off value was the minimum observed test value minus 1, and the largest cut-off value was the maximum observed test value plus 1. All the other cut-off values were the averages of two consecutive ordered observed test values. Results: Among the 53 patients in the study, 42 had exudative effusions (79.20%) and 11 had transudative effusions (20.80%). The common cause of exudative effusion was tuberculosis 26 (61.90%), followed by 9 malignancy (21.40%) and 7 parapneumonic effusion (16.70%). In our study, the pleural fluid CRP was statistically significant (p<0.001) marker to differentiate exudative effusions with CRP-value <30 suggestive of malignancy, CRP-value 30-50 mg/L suggestive of tuberculosis and CRP-value >70 mg/L suggestive of parapneumonic effusions. Conclusion: Determination of pleural fluid CRP is a useful diagnostic marker for differentiating exudative and transudative effusions. Also, Pleural fluid CRP is a statistically significant marker in differentiating tubercular effusions from nontubercular exudative effusions.


Author(s):  
Basanta Hazarika ◽  
Suresh Sharma ◽  
Ritesh Kumar ◽  
Jogesh Sarma

Background: Tuberculosis is a common cause of pleural effusion especially in countries like India. ADA (adenosine deaminase) is predominantly an enzyme, that catalyses the conversion of adenosine to ionosine. Usually patients with tuberculous pleural effusion have ADA level >40 U/L.Methods: This is a prospective, observational study conducted in Department of Pulmonary Medicine, Gauhati Medical College and Hospital, Guwahati from September 2016 to September 2017. 45 patients with pleural fluid ADA levels >40 U/L were selected with diagnosis of tubercular pleural effusion. Pleural fluid was analysed for cytological, biochemical and microbiological parameters along with ADA and malignant cell cytology. Anti-tubercular treatment (ATT) was started and pleural fluid ADA level were repeated after 15 days of ATT.Results: Pleural fluid ADA levels before the start of ATT intake and after 15 days of ATT intake were statistically analysed. Among 45 patients, 38 were male and 7 females.  Mean age of the patients was 45.42±16.43 years. Mean pleural fluid ADA level before starting ATT was 64.49±31.78 U/L. After 15 days of ATT intake mean pleural fluid ADA level was 36.11±10.42 U/L, p value was statistically significant (p<0.05).Conclusions: Pleural fluid ADA significantly decreased after 15days of initiation of anti-tubercular treatment. Pleural fluid ADA can be a useful tool as a follow up biomarker in cases of tubercular pleural effusion. 


2005 ◽  
Vol 63 (2) ◽  
Author(s):  
B. Uskul ◽  
H. Turker ◽  
C. Ulman ◽  
M. Ertugrul ◽  
A. Selvi ◽  
...  

Selvi, A. Kant, S. Arslan, M. Ozgel. Background: Residual pleural thickening (RPT) still occurs in most patients with tuberculosis pleurisy despite advances in the treatment of tuberculosis. The aim of this study was to evaluate the significance of RPT in tuberculosis pleurisy with the patients clinical findings, biochemical and microbiological properties of pleural effusion and with the total adenosine deaminase (ADA) and isoenzymes levels. Methods: 121 tuberculosis pleurisy patients were evaluated retrospectively. According to posteroanterior chest x-rays, the 63 (52%) cases with the thickness 2 mm or more in lower lateral hemithorax were grouped as I and the 58 (48%) cases without pleural thickness were grouped as II. The amount of pleural effusion was classified into small, medium or massive according to their chest x-rays. In both groups; sex, age, symptoms score, bacteriological and biochemical tests and ADA levels were recorded. Results: 81 (67%) male and 40 (33%) female, overall 121 patients were enrolled into the study. RPT was found higher in males (p=0.014) and the increase ran parallel with the amount of cigarette smoking (p=0.014). RPT was found to be lower in small effusions (p=0.001). The group with RPT, the serum albumin was found lower (p=0.002), pleural fluid total protein (p=0.047) and the ratio of pleural fluid protein to serum protein (p=0.002) were found higher. In group I, total ADA: 69.5±38.9 IU/L and ADA2: 41.3±31.6 IU/L were higher than the cases without RPT (p=0.032, p=0.017, respectively). Conclusions: We suggest that the immunological mechanisms are effective in the development of pleural thickening.


Author(s):  
Fatma Çiftci ◽  
Gulden Bilgin ◽  
Ayse Naz Ozcan ◽  
Ozlem Dogan ◽  
Aycan Yuksel ◽  
...  

2016 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Sayyed Gholam Reza Mortazavi-Moghaddam ◽  
Gholam Reza Sharifzadeh ◽  
Mohammad Reza Rezvani

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