Question of the Week

Question :

Posted On : 18 Jan 2006

How important is the role of determination of Adenosine Deaminase as a diagnostic aid for Childhood Tuberculosis ?

Expert Answer :

No expert answer available.

Answer Discussion :

pediatriconcall

Pleural fluid levels of adenosine deaminase {ADA} have been found to be high in patients with tuberculosis with sensitivity of 91.4 Percent.
Ref: J Clin Lab Anal. 2005,19{2}:40-6.

According to a study in China, When the level of ADA was higher than 45 U-L, the sensitivity, specificity and accuracy in the diagnosis of tuberculous ascites were 100 Percent, 97.1 Percent and 98.5 Percent.
Ref:Sichuan Da Xue Xue Bao Yi Xue Ban. 2003 Apr,34{2}:320-1.

According to a study in Africa, the median ADA level in the tuberculous pericarditis is 71.7 U-L {range, 10.3 to 303.6 U-L}, With a cut off activity of 30 U-L, sensitivity was 94 Percent, specificity was 68 Percent, and positive predictive value was 80 Percent.

Ref: Chest. 2002 Sep,122{3}:900-5.

According to a study in India, Mean CSF-ADA levels in TBM patients was 9.61 Plus 4.10 IU-L and was significantly elevated as compared to viral encephalitis and enteric encephalopathy cases, but difference was insignificant in comparison to pyogenic meningitis {7.92 Plus 0.95 IU-L} and cerebral malaria. Hence ADA in CSF may not be reliable for daignosis of TBM.
REf: J Assoc Physicians India. 1999 Feb,47{2}:192-4.

19 years ago

Rashna Dass

adenosine deaminase {ADA}cannot be used as a single marker to diagnose tuberculosis. However in a suggestive clinical setting and where all other attempts to prove the diagnosis remains negative it can be used as a supportive evidence of tuberculosis and helps to take a therapeutic decision. Where ever possible fluid when aspirated for analysis must also be sent for an estimation of ADA and if the levels are very much above the cut-offs suggested one can take it as supportive evidence for tuberculosis.

19 years ago

nikhil agrawal