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Article: Diagnostic value of pleural fluid adenosine deaminase activity in tuberculous pleurisy

TitleDiagnostic value of pleural fluid adenosine deaminase activity in tuberculous pleurisy
Authors
Issue Date2004
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/cca
Citation
Clinica Chimica Acta, 2004, v. 341 n. 1-2, p. 101-107 How to Cite?
AbstractBackground: Diagnosis of tuberculous pleuritis is difficult because of its nonspecific clinical presentation and insufficient efficiency of traditional diagnostic methods. We investigated the use of adenosine deaminase (ADA) activity in tuberculous pleuritis diagnosis. Methods: We optimized a kinetic assay and retrospectively analysed 210 patients with exudative pleural effusions. Using the ROC curve, we determined the optimal cutoff for TB pleurisy. Results: One hundred forty-seven exudative samples were nontuberculous (non-TB) and 63 were tuberculous (TB). There was statistically significant difference (p<0.0001) between the means of pleural fluid ADA levels among the TB and non-TB populations. The disease prevalence of TB pleurisy in the studied population was 30%. The cutoff value for diagnosing TB effusions was >55.8 U/L, with a sensitivity of 87.3% (95% CI: 76.5-94.3%) and specificity of 91.8% (95% CI: 86.2-95.7%). The positive predictive value (PPV) was 82.1% and the negative predictive value (NPV) was 94.4%. A pleural fluid ADA value <16.81 IU/L suggests that a tuberculous effusion is highly unlikely (100% sensitive with 100% NPV and 0% negative likelihood ratio for a pleural fluid ADA level≥16.81 U/L). In addition, the area under the ROC curve was 0.933 (S.E.=0.0230, 95% CI: 0.890-0.963). Conclusion: Pleural fluid total ADA assay is a sensitive and specific test suitable for rapid diagnosis of TB pleurisy. © 2004 Elsevier B.V. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/148381
ISSN
2015 Impact Factor: 2.799
2015 SCImago Journal Rankings: 1.040
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChen, MLen_US
dc.contributor.authorYu, WCen_US
dc.contributor.authorLam, CWen_US
dc.contributor.authorAu, KMen_US
dc.contributor.authorKong, FYen_US
dc.contributor.authorChan, AYWen_US
dc.date.accessioned2012-05-29T06:12:37Z-
dc.date.available2012-05-29T06:12:37Z-
dc.date.issued2004en_US
dc.identifier.citationClinica Chimica Acta, 2004, v. 341 n. 1-2, p. 101-107en_US
dc.identifier.issn0009-8981en_US
dc.identifier.urihttp://hdl.handle.net/10722/148381-
dc.description.abstractBackground: Diagnosis of tuberculous pleuritis is difficult because of its nonspecific clinical presentation and insufficient efficiency of traditional diagnostic methods. We investigated the use of adenosine deaminase (ADA) activity in tuberculous pleuritis diagnosis. Methods: We optimized a kinetic assay and retrospectively analysed 210 patients with exudative pleural effusions. Using the ROC curve, we determined the optimal cutoff for TB pleurisy. Results: One hundred forty-seven exudative samples were nontuberculous (non-TB) and 63 were tuberculous (TB). There was statistically significant difference (p<0.0001) between the means of pleural fluid ADA levels among the TB and non-TB populations. The disease prevalence of TB pleurisy in the studied population was 30%. The cutoff value for diagnosing TB effusions was >55.8 U/L, with a sensitivity of 87.3% (95% CI: 76.5-94.3%) and specificity of 91.8% (95% CI: 86.2-95.7%). The positive predictive value (PPV) was 82.1% and the negative predictive value (NPV) was 94.4%. A pleural fluid ADA value <16.81 IU/L suggests that a tuberculous effusion is highly unlikely (100% sensitive with 100% NPV and 0% negative likelihood ratio for a pleural fluid ADA level≥16.81 U/L). In addition, the area under the ROC curve was 0.933 (S.E.=0.0230, 95% CI: 0.890-0.963). Conclusion: Pleural fluid total ADA assay is a sensitive and specific test suitable for rapid diagnosis of TB pleurisy. © 2004 Elsevier B.V. All rights reserved.en_US
dc.languageengen_US
dc.publisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/ccaen_US
dc.relation.ispartofClinica Chimica Actaen_US
dc.subject.meshAdenosine Deaminase - Analysis - Metabolismen_US
dc.subject.meshAgeden_US
dc.subject.meshAsian Continental Ancestry Groupen_US
dc.subject.meshAutoanalysisen_US
dc.subject.meshBody Fluids - Enzymology - Microbiologyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPleura - Enzymology - Microbiologyen_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshTuberculosis, Pleural - Diagnosis - Enzymology - Microbiologyen_US
dc.titleDiagnostic value of pleural fluid adenosine deaminase activity in tuberculous pleurisyen_US
dc.typeArticleen_US
dc.identifier.emailLam, CW:ching-wanlam@pathology.hku.hken_US
dc.identifier.authorityLam, CW=rp00260en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.cccn.2003.11.016en_US
dc.identifier.pmid14967164-
dc.identifier.scopuseid_2-s2.0-1142309616en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-1142309616&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume341en_US
dc.identifier.issue1-2en_US
dc.identifier.spage101en_US
dc.identifier.epage107en_US
dc.identifier.isiWOS:000220128100013-
dc.publisher.placeNetherlandsen_US

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