Abstract

Objective: The objective of the study was to estimate the minimum value of adenosine deaminase (ADA) in tubercular (TB) and non-tubercularserosal effusions. Methods: The study was conducted on 336 subjects attending to OPD and IPD of TB chest and respiratory disease, Medicine and Orthopedics departments of Subharti Medical College and its associated hospital, Meerut, U.P. India. Out of these 155 subjects were tubercular (tubercular pleural effusion 45, peritoneal 34, synovial 34 and cerebrospinal fluid 42) and 181 were non tubercular (pleural 42, peritoneal 48, synovial 37 and cerebrospinal fluid 54). ADA levels of different serosal fluids were estimated by Microexpresskit, based on Guistiand Galantimethod. Data was analyzed by one way Anova. Results: In our study, we found the following cut off values of ADA in different types of serosaleffusions. In tubercular pleural effusion it was 65Unit/Litre (U/L), peritoneal 75U/L, synovial 42U/L and cerebrospinal fluid 13U/L respectively. In non-tubercular pleural effusion it was 6U/L, peritoneal 4U/L, synovial 13U/Land cerebrospinal fluid 2U/L respectively. Sensitivity and specificity of tubercular effusion were 100% and 0% respectively. While for non-tubercular pleural effusion it was 93% and 53%, for peritoneal 90% and 67%, for synovial and CSF it was 0%and 100% respectively. Conclusion: ADA estimation will be helpful as an alternative diagnostic method for early detection of TB and to differentiate between pulmonary and extra pulmonary tuberculosis.