Significance of Adenosine Deaminase Levels in Diagnosis of Pleural Effusion

The present study was carried out in 71 patients in a tertiary care center with an aim to study the correlation of results of ADA test and lymphocyte proportion with clinical / radiological findings and results of other relevant laboratory investigations. Diagnostic utility of pleural fluid ADA levels in the diagnosis of tubercular pleural effusion was also determined and values of ADA in patients with tubercular pleural effusion and non tubercular pleural effusion compared. Incidence of tubercular pleural effusion was more common in 21 to 40 years age group and among sex distribution males were commonly affected compared to females. Fever, cough and chest pain were common presentation among the cases in the study group. Elevated ADA levels were seen among the cases who had cough in the study group. Positive Mantoux test result had significantly elevated ADA levels among the cases in study group. Presence of chest pain among the cases in study group had raised ADA levels. Cardiomegaly and oedema among the cases in study group did not have significant association with levels of ADA in the study group. Presence of cavitatory lesions and infiltrations in the lung had significantly elevated ADA levels among the study group. LDH, Sugar, TLC and lymphocytic proportions were significantly correlated with ADA levels among the cases in study. Introduction Pleural effusion is the presence of excessive quantity of fluid in the pleural space. Though it produces minimal symptoms, it should be considered as a sign of serious disorder. So, no effort should be left in arriving at specific diagnosis to give the most rational treatment. Effusion may be transudative due to abnormalities of hydrostatic, or osmotic pressures and exudative from increased permeability or trauma. Etiological diagnosis is often difcult to establish. Although tuberculosis is the most common cause of effusion in developing countries like India, other causes should be excluded before labeling it as tuberculosis. Investigation of pleural effusion demands pleural aspiration and biopsy, but its invasive nature and diffcult technique limits its practice. The pleural fluid is sent for measurement of proteins and glucose content, cytological and microbiological examination. Cytology and microbiology benefit from testing as large quantity of fluid as possible. A “diagnostic tap” of 10-20 ml of pleural fluid without a pleural biopsy is inadequate. In as many www.jmscr.igmpublication.org Impact Factor 5.84 Index Copernicus Value: 71.58 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v5i11.217