Adenosine Deaminase Detection in Serum of Pulmonary Tuberculosis and Extra Pulmonary Tuberculosis patients at Dr. Ramelan Hospital Surabaya

Abstract

Diagnosis of active tuberculosis (TB) is the first step to determine the next treatment management of patient care. The success of the treatment will not be achieved without the determined accurate diagnosis rapidly. The definitive diagnosis of tuberculosis includes the presence of Mycobacterium tuberculosis through smear staining or histopathological examination or culture method or molecular methods, however some of the methods have limitations for TB diagnosis, especially on extrapulmonary tuberculosis (EPTB). In EPTB, culture method is time consuming till 6-8 weeks, where as it requires a rapid diagnosis, while tissue biopsy to obtain histopathological images is an invasive procedure. Likewise, the constrains on determining diagnosis of pulmonary TB (PTB) especially child TB and EPTB. In certain condition, the detected ADA level exceeds the detection limit as well as in TB disease with an active process. To study the meaning detection of Serum Adenosis Deaminase in serum of patients as an indicator in diagnosing of active disease process in Pulmonary and Extra Pulmonary Tuberculosis. This study was an observational study with a cross sectional study method, carried out in 8 months, by taking serum of blood samples from patients diagnosed with PTB and EPTB. The sample examination, then measuring the ADA serum levels using the ELISA method in Dr Ramelan Hospital Surabaya Indonesia, and cofirmed MTBC in blood samples using standard PCR of gyrB gene region in the Tuberculosis Laboratory, Tropical Disease Institute, Airlangga University, Surabaya, Indonesia. In totally 176 serum samples form PTB and EPTB patients, at January 2020 until December 2020, there were no significant results between serum Adenosine Deaminase (ADA) levels in diagnosing Pulmonary Tuberculosis and Extra Pulmonary Tuberculosis at Dr. Ramelan Hospital Surabaya. So, in this study, ADA serum levels could have the potential role in the diagnosis of pulmonary tuberculosis and EPTB, otherwise this study revealed that ADA serum activity is not a useful test for differentiating tuberculosis from other respiratory diseases, and could be an additional test especially for disease active progressive or recovery.