Keywords : Ascites
Diagnosis of Pulmonary and Extra-pulmonary Tuberculosis: Role of Adenosine Deaminase Levels in Different Body Fluids
Al- Anbar Medical Journal,
2021, Volume 17, Issue 2, Pages 64-67
Background: Tuberculosis (TB) is one of the major public health problems, particularly indeveloping countries. There are many tools to diagnose TB, one of them is the estimation of thelevel of adenosine deaminase (ADA) in various fluids in the body.Objectives: To find the role of ADA levels in 4 different types of body fluids to diagnose TB andextra-pulmonary TB.Materials and methods: This prospective study was conducted in the 3 main hospitals in Anbargovernorate, Iraq for one year from July 2019 to June 2020. Four types of body fluids [serumsamples, pleural fluid, ascetic fluid, and cerebrospinal fluid (CSF)] were collected from patients whowere suspected of having TB. The levels of ADA were measured by ELISA. An accurate diagnosisof TB was done by Genexpert real-time polymerase reaction (PCR). The results were comparedaccording to PCR findings.Results: Out of 176 patients, there were 31 patients were proved to be positive, for TB byGenexpert real-time PCR. The highest mean level of ADA in positive TB cases by PCR was inthe pleural fluid (58.258 ± 2.707), and the last was in the serum. There was a highly statisticallysignificant difference between the ADA levels in all 4 body fluids between the positive and negativeTB cases (P-value= 0.000). In the positive cases, the sensitivity of ADA levels in the serum, CSF,pleural fluid, and ascetic fluid were found to be 40%, 81%, 96%, and 94% respectively and thespecificity was found to be 88%, 72%, 94%, and 90% respectively.Conclusion: The ADA levels in all 4 body fluids were highly statistically significant differencebetween TB negative and positive cases diagnosed by PCR. However, they had different sensitivityand specificity levels.