Journal List > Korean Circ J > v.20(1) > 1072550

Park, Kim, Min, and Choe: Diagnostic Value of Adenosine Deaminase Activity in Tuberculous Pericardial Effusion

Abstract

Adenosine deaminase(ADA) is an enzyme capable of catalysing the pathway from adenosine to inosine. Previous studies have shown that this enzyme may be useful in recognition of a tubeculous etiology of pleural, peritoneal, or meningeal effusions.
ADA activity was studied in 42 patients with large amount of pericardial effusion. Patients were subdivided into the following four group : (A) 15 cases of tuberculous effusions : (B) 4 with pyogenic effusions : (C) 15 with idiopathic effusions : (D) 9 with malignant effusions.
The results were as follows ;
1) The mean ADA activities assessed in pericardial effusions were 134.0±77.6U/L in group A : 93.8±43.8 in group B : 38.3±23.2 in group C : 27.3±20.8 in group D. Comparing the level achieved in group A with all others, the difference is significant at the P<0.001 level.
2) The mean ADA activities assessed in sera were 50.7±57.2 U/L in group A : 63.5±24.1 in group B : 25.9±12.0 in group C : 14.0±7.5 in group D. Comparing the level achieved in group A with all others, there is no significant difference.
3) Specificity(0.87) and sensitivity(0.93) of the test for the differential diagnosis of patients with tuberculous effusion from those with idiopathic effusion is high, when a value of more than 50 U/L is considered.
In conclusion, the assessment of ADA in pericardial effusions is of great value in the diagnosis of tuberculous pericarditis.

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