Diagnostic value of adenosine deaminase in nontuberculous lymphocytic pleural effusions

  title={Diagnostic value of adenosine deaminase in nontuberculous lymphocytic pleural effusions},
  author={David Jim{\'e}nez Castro and Gema D{\'i}az Nuevo and Esteban P{\'e}rez-Rodr{\'i}guez and Richard W. Light},
  journal={European Respiratory Journal},
  pages={220 - 224}
Adenosine deaminase (ADA) can aid in the diagnosis of tuberculous pleural effusions, but false-positive findings from lymphocytic effusions have been reported. The purpose of this study is to assess the ADA levels in nontuberculous lymphocytic pleural effusions (lymphocyte count >50%) of different aetiologies. Altogether, 410 nontuberculous lymphocytic pleural fluid samples were consecutively selected. These included malignant effusions (n=221), idiopathic effusions (n=76), parapneumonic… 

Role of Adenosine Deaminase Estimation in Differentiation of Tuberculous and Non-tuberculous Exudative Pleural Effusions

In this study, ADA levels in nontuberculous exudative pleural effusions rarely exceeded the cut-off; set for tuberculous disease.

Role of pleural fluid adenosine deaminase activity and lymphocytosis in the etiological diagnosis

Adenosine Deaminase activity (ADA) level in tubercular pleural effusion is markedly increased compared to non-tubercular effusions and ADA estimation being a simple colorimetric method is suitable for the rapid diagnosis of tubercular effusion.

Adenosine deaminase activity in pleural effusions of lymphoma patients.

The use of P-ADA in NHL effusion could aid the separation of transudates from exudates in non-Hodgkin's lymphoma patients.

[Adenosine deaminase activity in tuberculous and malignant pleural effusions].

It is concluded that ADA measured by the Giusti method proceeded by the dilution 1:8 of the pleural effusion samples very good differentiates tuberculous from malignant pleurisy, without the necessity to determine the 2'-deoxyadenosine/ adenosine ratio.


Pleural fluid ADA levels at a cutoff value of 40U/L, showed sensitivity, specificity, positive predictive value and negative predictive value of 91.67%, 89.3%, 88% & 92.6% respectively in tuberculous effusion and CRP levels in parapneumonic effusion were significantly higher compared to other types of effusions.

Diagnostic value of pleural fluid adenosine deaminase among the patients with pleural tuberculosis

In patients with unexplained exudative pleural effusion especially in those who were suspicious for tuberculous pleurisy, despite the low level of ADA, direct thoracoscopic pleural observation and multiple biopsies of pleura is highly recommended.

Diagnostic Accuracy of Adenosine Deaminase and Lymphocyte Proportion in Pleural Fluid for Tuberculous Pleurisy in Different Prevalence Scenarios

Adenosine deaminase (ADA) remains useful for the diagnosis of TPE even in low-to-intermediate prevalence scenarios when combined with the lymphocyte proportion.

Differential Diagnosis of Tuberculous and Malignant Pleural Effusions: What is the Role of Adenosine Deaminase?

There is no doubt that pleuroscopy-guided biopsy is of great value for TPE diagnosis; however, sensitivity and specificity of noninvasive tests, especially ADA, can help to distinguish between TB and malignancy.

Evaluation of Adenosine Deaminase (ADA) Activity for Diagnosis of Tubercular Pleural Effusion

It is concluded that ADA levels are significantly high in patients with tuberculous pleural effusion compared to that in non-tubercular group and can be made quickly in a noninvasive way.



Value of adenosine deaminase in the diagnosis of tuberculous pleural effusions in young patients in a region of high prevalence of tuberculosis.

In a region with a high prevalence of tuberculosis procedures not involving pleural biopsy have a very high diagnostic yield in patients with a pleural effusion aged < or = 35 years, making biopsy necessary only in cases in which pleural levels of ADA are below 47 U/l.

Adenosine deaminase in the diagnosis of tuberculous pleural effusions. A report of 218 patients and review of the literature.

The results indicated that in a population with a relatively high prevalence of tuberculosis, the analysis of ADA levels in pleural effusions constitutes a useful marker for the diagnosis which, in addition, can be made quickly and cheaply.

Pleural Fluid Adenosine Deaminase and Lymphocyte Proportion: Clinical Usefulness In the Diagnosis of Tuberculosis

The combined use of ADA activity determination and lymphocyte proportion is a highly efficient diagnostic strategy of low cost, that merits wider use.

Combined use of pleural adenosine deaminase with lymphocyte/neutrophil ratio. Increased specificity for the diagnosis of tuberculous pleuritis.

ADA, especially when combined with differential cell counts and lymphocyte/neutrophil ratios, remains a useful test in the diagnosis tuberculous pleuritis.

Simultaneous measurements of adenosine deaminase activity and tuberculostearic acid in pleural effusions for the diagnosis of tuberculous pleuritis.

Results suggest that simultaneous measurements of both ADA and TSA in pleural effusions are useful for the diagnosis of tuberculous pleuritis.

Diagnosis of tuberculous pleurisy using the biologic parameters adenosine deaminase, lysozyme, and interferon gamma.

It is concluded that PADA and IFN are useful parameters for early diagnosis of tuberculous pleurisy, and that the other parameters considered have no advantages over PADA or IFN for this purpose (though the high specificity of P/SLYS may be noted).

Use of adenosine deaminase as a diagnostic tool for tuberculous pleurisy.

ADA activity remains a useful test in the evaluation of pleural effusions and at a level of 50 U/l the sensitivity and specificity for the identification of tuberculosis was 90% and 89%, respectively.

Pleuritis as a manifestation of reactivation tuberculosis.

Clinical and pathological features of tuberculous pleural effusion and its long-term consequences.

A retrospective study of 83 cases of tuberculous pleural effusion showed that the mean age of the patients was 44 years and 10 patients (12%) were over the age of 70, and Pleural biopsy was a more sensitive method of diagnosis with granulomatous inflammation seen in 97% of cases.