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The diagnostic utility of adenosine deaminase isoenzymes in tuberculous pleural effusions

dc.contributor.authorZemlin A.E.
dc.contributor.authorBurgess L.J.
dc.contributor.authorCarstens M.E.
dc.date.accessioned2011-05-15T16:16:46Z
dc.date.available2011-05-15T16:16:46Z
dc.date.issued2009
dc.identifier.citationInternational Journal of Tuberculosis and Lung Disease
dc.identifier.citation13
dc.identifier.citation2
dc.identifier.issn10273719
dc.identifier.urihttp://hdl.handle.net/10019.1/13925
dc.description.abstractSETTING: Pleural adenosine deaminase (ADA) levels have been found to be useful in diagnosing tuberculous pleuritis. Elevated ADA levels have been attributed to ADA2 isoenzyme, although no comprehensive studies have evaluated ADA2 as a diagnostic test. OBJECTIVE: To estimate the diagnostic accuracy of ADA and ADA2 in diagnosing tuberculous pleurisy. METHOD: A 3-year retrospective study was carried out. ADA and ADA 2 were determined on patients diagnosed according to predetermined criteria. RESULTS: A total of 951 samples were received, including 387 patients with tuberculosis (TB). ADA values ≥52.4 U/l yielded a sensitivity, specificity and positive (PPV) and negative predictive value (NPV) respectively of 93.7% (95%CI 90.0-96.0), 88.7% (95%CI 85.7-91.3), 85.5% (95%CI 81.7-88.8) and 95.2% (95%CI 92.9-96.9). ADA2 values ≥40.6 U/l yielded a sensitivity, specificity and PPV and NPV of respectively 97.2% (95%CI 95.0-98.7), 94.2% (95%CI 91.8-96.0), 92.2% (95%CI 89.1-94.7) and 98.0% (95%CI 96.3-99.0). The χ2 and McNemar tests proved the superiority of ADA2 statistically. CONCLUSION: ADA2 is superior to ADA in the diagnosis of tuberculous pleuritis and should be used as a routine test in the diagnostic work-up of patients with pleural effusions in areas with high TB prevalence. © 2009 The Union.
dc.subjectadenosine deaminase
dc.subjectisoenzyme
dc.subjectarticle
dc.subjectdiagnostic accuracy
dc.subjectdiagnostic test
dc.subjectenzyme activity
dc.subjectfemale
dc.subjecthuman
dc.subjecthuman tissue
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmedical record review
dc.subjectpleura fluid
dc.subjectprediction
dc.subjectpriority journal
dc.subjectretrospective study
dc.subjectsensitivity and specificity
dc.subjectsputum culture
dc.subjecttuberculous pleurisy
dc.subjectAdenosine Deaminase
dc.subjectAdult
dc.subjectFemale
dc.subjectHumans
dc.subjectIsoenzymes
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectPleural Effusion
dc.subjectPleurisy
dc.subjectPredictive Value of Tests
dc.subjectRetrospective Studies
dc.subjectTuberculosis, Pleural
dc.titleThe diagnostic utility of adenosine deaminase isoenzymes in tuberculous pleural effusions
dc.typeArticle
dc.description.versionArticle


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