Malleswari Belle, Shridhar Baburao, Rahul Baburao Kamble, Pranav Punasanwala
BACKGROUND To study the clinical profile of paediatric tuberculosis with reference to adenosine deaminase level in comparison with DNA PCR for diagnosis of mycobacterium tuberculosis. Tuberculosis is still a leading cause of death worldwide. After a century of stagnation, new technologies for the diagnosis of tuberculosis, new molecular based technologies were approved for the detection of Mycobacterium tuberculosis. MATERIALS AND METHODS In the study, 50 patients of tuberculosis were studied in detail regarding presentation of various forms of tuberculosis (TB meningitis, pulmonary tuberculosis) with respect to age of presentation, BCG vaccination status, and sex distribution, history of contact, MT positivity, and clinical features. Investigations done were Complete Blood Count with peripheral smear, ESR, chest x-ray, acid fast staining of (sputum, gastric aspirate, pleural fluid), CSF routine & micro in case of TB meningitis, pleural fluid routine & micro in cases of TB pleural effusion. DNA PCR and ADA level of body fluids (CSF, pleural fluid, blood) were done. RESULTS Among the 50 patients of tuberculosis, 30 patients were diagnosed with TB meningitis. In these Tb Meningitis cases, 2 patients were positive for DNA PCR & 18 patients had high ADA level. Of the 15 patients of tubercular pleural effusion, one patient was DNA PCR positive and 10 patients had high ADA level. In 5 patients of pulmonary tuberculosis, 1 patient tested positive for DNA PCR and 3 patients for high ADA level. CONCLUSION Our results show that, neither PCR nor ADA activity should be relied on as a single test that substitutes for the diagnostic methods already available, but rather they should be used as an extra tool in the diagnosis of TB. The combined analysis of PCR and ADA activity, however, is a very useful diagnostic approach to achieve a more rapid and precise diagnosis in the cases of tuberculosis.
