Evaluation of adenosine deaminase activity for the diagnosis of pleural TB in lymphocytic pleural effusions.

Cyro Teixeira da Silva, Rodolfo Fred Behrsin, Gilberto Perez Cardoso, Elizabeth Giestal de Araújo

Departamento de Medicina Clínica da Faculdade de Medicina da Universidade Federal Fluminense, Rio de Janeiro, Brazil. ctsilvajunior@predialnet.com.br

Biomarkers in medicine 2013 Feb

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To evaluate the diagnostic value of pleural adenosine deaminase (P-ADA) as a pleural TB-specific biomarker in lymphocytic pleural effusions. Pleural effusions were classified on the basis of definitive diagnosis. A total of 218 patients (122 tuberculous and 96 nontuberculous) were included in the study. The optimal cut-off value of P-ADA (receiver operating characteristic curve) for the diagnosis of pleural TB was 40.0 U/l (Giusti method). In lymphocytic pleural effusions P-ADA had a sensitivity of 80.3%, a specificity of 96.0% and an accuracy of 86.2%. The positive predictive value was 97.0% and the negative predictive value was 75.0%. The positive likelihood ratio and negative likelihood ratio were 19.8 and 0.2, respectively (p < 0.0001). P-ADA activity is recommended for the diagnosis of TB in lymphocytic pleural effusions.

Citation

Cyro Teixeira da Silva, Rodolfo Fred Behrsin, Gilberto Perez Cardoso, Elizabeth Giestal de Araújo. Evaluation of adenosine deaminase activity for the diagnosis of pleural TB in lymphocytic pleural effusions. Biomarkers in medicine. 2013 Feb;7(1):113-8