Diagnostic significance of adenosine deaminase (ADA) activity in patients of pulmonary tuberculosis with and without pleural effusion

Tuberculosis (TB) is one of the oldest and commonest infectious diseases also known as “master of Death”. Pulmonary TB (PTB) and TB with pleural effusion remains a diagnostic challenge. Adenosine deaminase (ADA) is an enzyme of purine catabolism which is an inexpensive and easy test in early routine evaluation of patients with pleural effusion. Aim: To assess the diagnostic level of ADA in TB patients with and without pleural effusion and in non-tuberculosis pleural effusion. Materials and method: Study comprised of 120 subjects of which 30 are healthy controls and 30 are confirmed cases of pulmonary TB without effusion, 30 are PTB with effusion and 30 are non-TB effusion patients. Age group range was from 2575 years. Estimation of serum and pleural fluid Adenosine deaminase by Giusti and Galanti method of enzymatic analysis. Results: Serum ADA levels in pulmonary tuberculosis (55.07 + 11.04) patients and pulmonary tuberculosis with pleural effusion (44.01 + 7.83) were significantly higher (p<0.001) when compared with healthy controls (18.09 + 6.15). Pleural fluid ADA levels were significantly higher (p<0.0001) in pulmonary tuberculosis with pleural effusion (82.63 + 12.02) than in non-tuberculosis pleural effusion (27.71 +7.81).In the present study, the mean pleural fluid ADA were significantly higher as compared to mean serum ADA in pulmonary tuberculosis with pleural effusion (p<0.0001) and in nontuberculosis pleural effusion (p<0.0008). Conclusion: ADA level in serum as well as in pleural fluid in the diagnosis of pulmonary TB with or without pleural effusion is a very sensitive, specific, inexpensive, rapid, easily available & reliable investigation.