Pleural effusion adenosine deaminase (ADA) level and occult tuberculous pleurisy.

Motoki Sakuraba, Kimihiko Masuda, Akira Hebisawa, Yuzo Sagara, Hikotaro Komatsu

Department of Thoracic Surgery, National Hospital Organization Tokyo Hospital, Japan.

Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia 2009 Oct

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We investigated the incidence of tuberculous pleurisy among patients with adenosine deaminase (ADA) levels of 50 IU/L or less in a pleural effusion, and without a previous diagnosis of carcinomatous pleurisy or Mycobacterium tuberculosis. Subjects were selected from patients who had undergone pleural biopsy by thoracoscopy at National Hospital Organization Tokyo Hospital from January 1995 to November 2004, and who had ADA levels of less than 50 IU/L in pleural fluid obtained preoperatively by thoracentesis. In all subjects, smear, culture, and polymerase chain reaction for Mycobacterium tuberculosis were negative. Of 138 patients who underwent thoracoscopic pleural biopsy, a total of 50 had effusions with ADA levels of less than 50 IU/L. Six (12%) of these patients were diagnosed with tuberculous pleurisy after biopsy. Three patients with an effusion ADA level of 35 IU/L or less were diagnosed with tuberculous pleurisy. Occult tuberculous pleurisy is significantly common in patients with pleural effusion ADA levels of 50 IU/L or less and who may otherwise be diagnosed with nonspecific pleurisy.

Citation

Motoki Sakuraba, Kimihiko Masuda, Akira Hebisawa, Yuzo Sagara, Hikotaro Komatsu. Pleural effusion adenosine deaminase (ADA) level and occult tuberculous pleurisy. Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia. 2009 Oct;15(5):294-6