Comparison of Different Laboratory Routine Methods with Adenosine Deaminase Test for Diagnosis of Tuberculous Pericarditis in Two Iranian Teaching Hospitals, Tehran, Iran

Abstract

In this study, laboratory routine tests were compared with adenosine deaminase (ADA) test for diagnosis of tuberculous pericarditis. Sampling was performed among 30 patients admitted to two Iranian teaching hospitals (Imam and Modarres). For each patient two specimens were obtained from the pericardial fluid and biopsy. Pericardial fluid was used for staining, culture and measuring of ADA activity. The biopsy specimens were homogenized and cultured on Lowenstein-jensen media too and examined by H & E stain for presence of caseous granulomas and tubercule bacilli. In this survey, the ADA activity level of less than 45 μL-1 in pericardial fluid were determined as negative, while more than 45 μL-1 were considered as positive reaction indicating of tuberculous pericarditis. In this study, from a total of 30 subjects, tuberculous pericarditis was diagnosed by routine laboratory tests in 13 patients who all had clinical symptoms of the disease. Tuberculous pericarditis was diagnosed by positive results of pericardial fluid cultures in 6 of 13 patients (46.2), by pericardial biopsy cultures in 6 patients (46.2), by pericardial fluid staining in 3 patients (23.1) and by tuberculin skin test in 10 patients (76.9). Finally we observed that all of 13 patients with tuberculous pericarditis had ADA levels of more than 45 μL-1 in their pericardial fluids. The results of the present study confirmed that high levels of ADA have a prognostic value and due to its high specificity and sensitivity and also being faster and easier than laboratory routine tests, so this test can utilized as effective diagnostic method for diagnosis of tuberculous pericarditis. © 2006 Asian Network for Scientific Information.