Abstract
Background: Tuberculosis (TB), a communicable disease, caused by Mycobacterium tuberculosis requires a simple, rapid test, which can be easily carried out in a laboratory. Unfortunately, despite a battery of investigations, no definite test is available till date. Adenosine deaminase (ADA), a biochemical marker has been proposed as a useful surrogate marker for TB as its levels can be measured in body fluids.
 Methods: A one-and-a-half-year prospective study of 154 cases presenting with lymphadenitis from January 2019 to June 2020 was undertaken. Using cytology, lymphadenitis subjects were divided into two groups: Tubercular (104 patients) as a case group and Reactive (50 patients) as a control group. All cases were followed by serum ADA assay by colorimetric method. Nonparametric tests were performed to compare the two groups.
 Results: The mean age of the participants was 28.99 ± 13.26 years with a F:M ratio of 1.81:1. Involvement of cervical lymph nodes was most frequent (89.42% cases). The mean S.ADA level for tubercular and reactive lymphadenitis was 41.71 ± 11.53 U/L and 21.16 ± 4.16 U/L, respectively (P-value < 0.05). The cut-off value calculated was 32.6 U/L. The sensitivity, specificity, PPV, NPV, and accuracy were calculated as 79.81%, 100%, 100%, 70.42%, and 86.36%, respectively.
 Conclusion: A statistically significant increase was found in serum ADA levels in tubercular lymphadenitis cases compared to reactive lymphadenitis. Hence, it can be used as an adjunct to FNAC and is a fairly sensitive and specific test. Since it is difficult to always demonstrate AFB in FNAC smears, ADA can be helpful in establishing a definite diagnosis despite smear negativity.
 Keywords: adenosine deaminase, lymphadenitis, tuberculosis
Highlights
Tuberculosis (TB), a transmittable disease, is amongst the top 10 worldwide causes of death and is the principal cause of fatality from a single infectious vehicle rankingHow to cite this article: Ina Garg, Deepti Arora, Himanshu Joshi, Ashutosh Kumar, and Seema Awasthi (2021) “Association of Serum AdenosineDeaminase Levels in Cytologically Suggested Cases of Tubercular Lymphadenitis: The Experience of a Tertiary Care Centre,” Sudan Journal of Page 386Medical Sciences, vol 16, Issue no. 3, pages 386–398
Out of the 104 patients that presented with cytological features suggestive of tubercular lymphadenitis, 37 were male and 67 female
The raised serum Adenosine deaminase (ADA) level can be considered as a reliable indicator of tubercular lymphadenitis and is a fairly sensitive and specific test
Summary
Tuberculosis (TB), a transmittable disease, is amongst the top 10 worldwide causes of death and is the principal cause of fatality from a single infectious vehicle rankingHow to cite this article: Ina Garg, Deepti Arora, Himanshu Joshi, Ashutosh Kumar, and Seema Awasthi (2021) “Association of Serum AdenosineDeaminase Levels in Cytologically Suggested Cases of Tubercular Lymphadenitis: The Experience of a Tertiary Care Centre,” Sudan Journal of Page 386Medical Sciences, vol 16, Issue no. 3, pages 386–398. Deaminase Levels in Cytologically Suggested Cases of Tubercular Lymphadenitis: The Experience of a Tertiary Care Centre,” Sudan Journal of Page 386. Lymphadenitis subjects were divided into two groups: Tubercular (104 patients) as a case group and Reactive (50 patients) as a control group. The mean S.ADA level for tubercular and reactive lymphadenitis was 41.71 ± 11.53 U/L and 21.16 ± 4.16 U/L, respectively (P-value < 0.05). Conclusion: A statistically significant increase was found in serum ADA levels in tubercular lymphadenitis cases compared to reactive lymphadenitis. It can be used as an adjunct to FNAC and is a fairly sensitive and specific test. Since it is difficult to always demonstrate AFB in FNAC smears, ADA can be helpful in establishing a definite diagnosis despite smear negativity
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