Adenosine Diaminase Activity Level in Exudative Lymphocytic Predominated Pleural Effusion in Maharat Nakhon Ratchasima Hospital
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Abstract
Background: Adenosine deaminase activity (ADA) was tooled in differential diagnosis between tuberculosis pleuritis (TBP) and malignant pleural effusion (MPE) which presented with exudative lymphocytic predominated but no data collection in Maharat Nakhon Ratchasima Hospital to show clinical utility of this test. Objective: To study clinical utility of ADA for diagnosis TBP in exudative lymphocytic predominated pleural effusion in Maharat Nakhon Ratchasima Hospital. Patient & Methods: Retrospective descriptive and analytic study from in-patient data of the first diagnosis is TBP, were collected since January 1, 2005-June 30, 2005. Results: Exudative lymphocytic predominated pleural effusion that first diagnosis were TBP 47 persons were changed the diagnosed to TBP, MPE and parasite infestation (40, 6 and 1). ADA in pleural fluid was sent and found the results 32 specimens. ADA level in TBP is higher than MPE significantly (p=0.005). In this study low ADA level (<40 IU/ml) can not rule out TBP and high ADA level (>60 IU/ml) can found in MPE. Parasite infestation had also high ADA level (>60 IU/ml). Sensitivity of cytology and pathology for diagnosis MPE were 50.0% and 27.3 %. Conclusion: ADA may have clinical utility in differential diagnosis between TBP and MPE, high level (>60IU/mL) favor TBP than MPE.
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