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1- Department of Respiratory Medicine, Narendra Modi Medical College, Maninagar, Ahmedabad, India
2- NHL Municipal Medical College, Paldi, Ahmedabad, India , shishugarg@yahoo.com
Abstract:   (314 Views)
Background: The sputum smear-negative pulmonary tuberculosis (PTB) is a diagnostic challenge for physicians. It has been shown that adenosine deaminase (ADA) activity increases in various body fluids of patients with tuberculosis (TB). A prospective clinical trial was conducted to determine the effectiveness of ADA activity in bronchoalveolar lavage (BAL) in subjects who have sputum smear-negative PTB.
Methods: A total of 29 patients (M/F: 15/14), mean age (36.8 years), were enrolled in our study from October 2021 to August 2022 after providing written consent. The mean duration of symptoms was 41.66 days. Out of 29 patients, 21 patients had BAL ADA 4.81±1.68 unit??, for whom AKT treatment was started and cured, while four patients with BAL ADA 4.50±2.86 unit? did not improve, and four patients with BAL ADA 6.52±1.16 whose AKT treatment is ongoing at present but clinically improved. The sensitivity of BAL ADA with the outcome of 29 patients is 75%, while for BAL CBNAAT, it is 80%. When we apply a formula for combined sensitivity for the parallel test, then it comes to 95%, which indicates a great number of patients gets the benefit when we apply both tests simultaneously.
Results: We conclude that ADA activity was significantly increased in BAL.
Conclusion: BAL ADA is a useful and effective investigation for the diagnosis of PTB.

 
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Research Article: Research Article | Subject: bacteriology
Received: 2023/01/12 | Accepted: 2024/02/21 | Published: 2024/05/30 | ePublished: 2024/05/30

References
1. Caramori G, Lasagna L, Casalini AG, Adcock IM, Casolari P, Contoli M, et al. Immune response to Mycobacterium tuberculosis infection in the parietal pleura of patients with tuberculous pleurisy. PLoS One. 2011; 6(7): e22637. [View at Publisher] [DOI] [PMID] [Google Scholar]
2. Jeong YJ, Lee KS. Pulmonary tuberculosis: Up-to-date imaging and management. AJR Am J Roentgenol. 2008; 191: 834-44. [View at Publisher] [DOI] [PMID] [Google Scholar]
3. Hallur V, Sharma M, Sethi S, et al. Development and evaluation of multiplex PCR in rapid diagnosis of abdominal tuberculosis. Diagnostic Microbiology and Infectious Disease. 2013; 76(1): 51-55. [View at Publisher] [DOI] [PMID] [Google Scholar]
4. Klimiuk J, Krenke R. Role of biomarkers in making the diagnosis of tuberculous pleurisy. Pneumonol Alergol Pol. 2011; 79(4): 288-297. [View at Publisher] [PMID] [Google Scholar]
5. Kayacan O, Karnak D, Delibalta M, Beder S, Karaca L, Tutkak H. Adenosine deaminase activity in bronchoalveolar lavage in Turkish patients with smear negative pulmonary tuberculosis. Respiratory Medicine. 2002; 96(7): 536-541. [View at Publisher] [DOI] [PMID] [Google Scholar]
6. Orphanidou D, Gaga M, Rasidakis A, Dimakou K, Toumbis M, Latsi P, et al. Tumour necrosis factor, interleukin-1 and adenosine deaminase in tuberculous pleural effusion. Respir Med. 1996; 90(2): 95-8. [View at Publisher] [DOI] [PMID] [Google Scholar]
7. Piras MA, Gakis C, Budroni M, Andreoni G. Adenosine deaminase activity in pleural effusions: an aid to differential diagnosis. British Medical Journal. 1978; 2(6154): 1751-52. [View at Publisher] [DOI] [PMID] [Google Scholar]
8. Valdés L, San José E, Alvarez D, Sarandeses A, Pose A, Chomón B, Alvarez-Dobaño JM, Salgueiro M, et al. Diagnosis of tuberculous pleurisy using the biologic parameters adenosine deaminase, lysozyme, and interferon gamma. Chest. 1993; 103(2): 458-465. [View at Publisher] [DOI] [PMID] [Google Scholar]
9. Bueso JF, Hernando HV, Garcia-Buela JP, Juncal LD, Egana MTM, Martinez MCM. Diagnostic value of simultaneous determination of pleural adenosine deaminase and pleural lysozyme/serum lysozyme ratio in pleural effusions. Chest. 1988; 93(2): 303- 7. [View at Publisher] [DOI] [PMID] [Google Scholar]
10. Kubota M, Katagiri M, Yanase N, Soma K, Tomita T. Measurement of adenosine deaminase activity in bronchoalveolar lavage fluids as a tool for diagnosing miliary tuberculosis. Nihon KyobuShikkan Gakkai Zasshi. 1996; 34(2): 139-144. [View at Publisher] [DOI] [PMID] [Google Scholar]
11. Choi SH, Kim YS, Bae IG, et al. The possible role of cerebrospinal fluid adenosine deaminase activity in the diagnosis of tuberculous meningitis in adults. Clinical Neurology and Neurosurgery. 2002; 104(1): 10-15. [View at Publisher] [DOI] [PMID] [Google Scholar]

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