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 25- 75 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 non-tuberculosis 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.