A study on adenosine deaminase activity in pleural effusion of tuberculous and non tuberculous origin

Abstract

Introduction: Accumulation of fluid in the pleural space that exceeds the physiological amount is defined as pleural effusion. Pleural effusion can be either transudative or exudative. The exudative pleural effusion is predominantly observed in tuberculosis. Adenosine deaminase (ADA) level remains high in disorders where cellular immunity is stimulated. Tuberculosis is one such disease. Materials and Methods: The cases were classified as two groups. 30 patients of tubercular pleural effusion were enrolled in Group I and 30 patients of non-tubercular pleural effusion were Group II. In non-tubercular pleural effusion, 6 cases were malignant effusions, 12 cases were parapneumonic effusions and 12 cases were transudative effusions, which include 4 cases of congestive cardiac failure, 4 cases of nephrotic syndrome and 4cases of hepatic cirrhosis. The following biochemical parameters in pleural fluid were estimated. They are Glucose, Protein and Adenosine deaminase. Results: In this study mean pleural fluid glucose level was significantly higher in transudative when compared to exudative pleural effusions. In exudative pleural effusions, mean pleural fluid protein level was increased significantly as compared to transudative pleural effusions. The activity of ADA in tubercular effusion was significantly higher when compared to non tubercular pleural effusions of different etiology such as malignant parapneumonic and transudative. Conclusion: The assessment of ADA act as better marker for identifying tuberculosis than the traditional markers. Keywords: Pleural effusion, Exudative, Transudative, Tuberculosis, Adenosine deaminase.