Poonam Nanwani1, Anil Kapoor2, Sativan Khatri3
INTRODUCTION
The diagnosis of tuberculosis continues to be a challenge. More than 90% of TB effusions show a lymphocytic predominance, hence TB requires exclusion in any lymphocytic exudative effusion where no alternative cause is found.
AIMS & OBJECTIVE The objective of the present study was to validate the usefulness of adenosine deaminase (ADA) levels in lymphocytic body fluid (lymphocyte count >50%) in the diagnosis of TB.
METHOD AND MATERIAL
It was a prospective study and 300 lymphocytic body fluids were studied during the period of 1 year from June 2007 to August 2008 at department of Pathology. ADA level was estimated in all these samples.
RESULTS
Among 300 cases studied, including all age group and male predominance and using a cut off level of 55 unit/L of pleural fluid ADA, specificity 86.67%, the sensitivity 93.51%, false positive rate was 6.73%. For ascitic fluid, using a cut off level of 60 units/L of, specificity 94.44%, the sensitivity 92%, false positive rate was 14.30%. For CSF ADA, using a cut off level of 10 units/L of, specificity 97.56%, the sensitivity 88.57%.
CONCLUSION
We found that ADA when combined with lymphocyte >50%, remains a useful test in the diagnosis. ADA level were significantly reduced with antitubercular therapy, so we can use ADA as a prognostic marker of tuberculosis.
