Adenosine deaminase cutoff value when diagnosing tuberculous pleurisy in patients aged 40 years and older. (6th October 2020)

• Record Type: Journal Article
• Authors: Arpinar Yigitbas, Burcu; Satici, Celal; Kosar, A. Filiz
• Is Part Of: Clinical respiratory journal. Volume 15:Number 1(2021)
• Page Start: 109
• Page End: 115
• Publication Date: 2020-10-06
• Subjects: adenosine deaminase -- aged -- diagnosis -- pleural effusion -- tuberculosis; Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Periodicals; 616.24
• DOI: 10.1111/crj.13277
• Languages: English
• ISSNs: 1752-6981

Abstract

Abstract: Introduction: Tuberculous pleurisy (TBP) is one of the most common manifestations of extra‐pulmonary tuberculosis. In patients aged ≥40 years, a closed needle pleural biopsy is recommended with an adenosine deaminase (ADA) level of 40‐70 U/L. We aim to investigate whether the cutoff value of ADA and the cancer ratio in patients with TBP aged ≥40 years is different and determine the effects of both compounded biomarkers on diagnosing TBP. Materials and Methods: Between 2009 and 2016, the ADA levels were measured in pleural effusions from patients who were admitted to the Chest disease clinic. Results: Of the 196 patients included in the study, 104 were aged ≥40 years. A significant relationship was found between the serum LDH/pleural ADA (sLDH/pADA) ratio and ADA levels in patients aged >40 years (OR: 0.935 and OR: 1.085, respectively). The model using an ADA value ≥30 and an sLDH/pADA ratio <16 yielded a sensitivity of 94.25% (95% CI, 87.1‐98.10) in all patients and 69.23% (95% CI, 54.9‐81.28) in patients aged >40 years. Conclusion: ADA and the sLDH/pADA ratio are simple, cost‐efficient, and obtain fast results and, therefore, are the preferred methods in TBP diagnosis. The diagnosis rate in the present study was 91% using ADA levels in combination with the sLDH/pADA ratio, both of which can be obtained only through thoracentesis.