Lymphocytic Pleural Effusion and an Enzyme Involved in Purine Metabolism: A Tertiary Care Experience in Karachi, Pakistan.

BACKGROUND

The levels of adenosine deaminase (ADA) are increased in tubercular pleural effusion and its determination has acquired popularity as a diagnostic test which is inexpensive and is readily accessible. Pleural fluid ADA showed sensitivity (86.36%), specificity (61.54%), diagnostic accuracy (80.70%), positive predictive value (88.37%), and negative predictive value (82.42%) confirmed by pleural biopsy as a gold standard.

METHODOLOGY

Our study was a prospective cross-sectional study which was conducted for three years at a tertiary care center in Karachi, Pakistan. The data were collected and analyzed using IBM statistics SPSS vs21.

RESULTS

There were 52 patients included in our study. Twenty one were males and thirty one were females. Most patients presented with shortness of breath. There was a significant association found between raised ADA levels and pulmonary tuberculosis (p < 0.05). The ADA levels are 12 times more likely to be raised in tubercular pleural effusion.

CONCLUSION

The ADA level is an important marker for diagnosis of pulmonary tuberculosis in lymphocytic pleural effusion. It is a convenient and an inexpensive method. The ADA levels assessment is economical when compared to other diagnostic methods.