Mary carmen prezaguilar 1, loredana goncalves 1 y rafael bonfantecabarcas 2. The objective of this study was to evaluate the sensitivity of ada in pleural fluid in patients with low cd4 counts. It is less than 10% in countries with low tuberculosis burden, whereas it is re. Abdominopelvic tb is the sixth most common location of extrapulmonary tb. These studies have defined arbitrary cutoff points creating difficulties in the clinical application of the results. Advantages and disadvantanges of adenosine deaminase.
Several studies have suggested the role of adenosine deaminase ada in the diagnosis of tuberculous pleural effusions, but falsepositive results. Little is known about their usefulness when estimated in. To prepare mycobacterium culture, which is the golden standard for tb diagnosis, it may take 8 weeks. Very high level of adenosin deaminasa ada in pleural effusions. In some studies, the level of adenosine deaminase ada in sputum and effusion liquids was used for the diagnosis of tuberculosis tb. Tuberculosis pleural effusions can now be diagnosed accurately by increased levels of pleural fluid adenosine deaminase, above 40 u per liter. Adenosine deaminase ada can aid in the diagnosis of tuberculous pleural effusions, but falsepositive. Role of adenosine deaminase estimation in differentiation of. Extrapulmonary tb is uncommon and only accounts for 1020% of overall tb disease burden. Transmission occurs when a person inhales droplet nuclei containing. Sixteen studies in a total of 4,147 patients, 1,172 of whom had tuberculous pleural effusions, were included.
Reported tb cases united states, 19822011 ses year cdc. It is needed for the breakdown of adenosine from food and for the turnover of nucleic acids in tissues its primary function in humans is the development and maintenance of the immune system. Mar 31, 2010 tuberculosis kills five lakh patients every year in india, commonest being pulmonary tuberculosis and is often associated with effusion. Tuberculosis kills five lakh patients every year in india, commonest being pulmonary tuberculosis and is often associated with effusion. Tuberculosis is the principal cause of pleural exudates in countries with a high prevalence of this disease. Health care resources for this disease expert centres diagnostic tests 46 patient organisations 36 orphan drug s akio ohta 30 estimated hindex. Tb usually affects the lungs, but it can also affect other parts of the body, such as the brain, the kidneys, or the spine.
The sensitivity and specificity of adenosine deaminase for tubercular effusions in this study was 90% and 50% respectively. Very high level of adenosin deaminasa ada in pleural effusions, uncommon in tuberculosis. Value of adenosine deaminase ada in ascitic fluid for. The current methods for the diagnosis of tuberculosis tb do not provide enough sensitivity and specificity. Corteguera m, melero m, rey c, villar j, lapetra j, carnea do j. Use of adenosine deaminase ada as a parameter in the diagnosis of patients with. Severe combined immunodeficiency scid due to adenosine deaminase ada deficiency is a form of scid characterized by profound lymphopenia and very low immunoglobulin levels of all isotypes resulting in severe and recurrent opportunistic infections. This study suggests that the estimation of adenosine deaminase activity in pleural fluid is a rapid diagnostic tool for differentiation of tubercular and non tuberculareffusions. To show and prove the utility of the determination of adenosine deaminase levels ada and its isoenzymes ada1 and ada2 in the pleural. Ada had 93% sensitivity, 92% specificity, positive likelihood ratio of 12, negative likelihood ratio of 0. Adjunctive corticosteroids may be useful in patients who have tuberculous meningitis, tuberculous pericarditis, or miliary tuberculosis with refractory hypoxemia. Adenosine deaminase ada is an enzyme that catalyzes the deamination of adenosine and 2deoxyadenosine to inosine and 2deoxyinosine.
The material is in no way intended to replace professional medical care by a qualified specialist and should not be used as a. The diagnostic value of adenosine deaminase activity in. Tuberculosis tb remained as one of the top 10 causes of death worldwide despite an overall decline in its incidence rate globally. Pleural fluid ada activity in tuberculous pleurisy can be. Tuberculosis tb is one of the main reasons of mortality and morbidity globally and it kills about two million people annually.
Tuberculosis airborne disease caused by the bacterium mycobacterium tuberculosis m. Diagnostic value of adenosine deaminase in nontuberculous. Role of gproteincoupled adenosine receptors in downregulation of inflammation and protection from tissue damage. Very high level of adenosin deaminasa ada in pleural effusions, uncommon in tuberculosis patricia lazo meneses. The use of adenosine deaminase assays in the diagnosis of tuberculosis.
Pdf value of adenosine deaminase ada in ascitic fluid. Abdominopelvic tuberculosis secondary to a nontuberculous. Increased adenosine deaminase serum activity in patients with acute myocardial infarction. Download fulltext pdf adenosine deaminase deficiency. A positive result indicates that a person has been infected with the tuberculosis bacteria at some point in his or her life. Tuberculosis tb is a disease caused by germs that are spread from person to person through. Diagnostic value of serum adenosine deaminase level in. Diagnosis can be confirmed by raised levels of datp and reduced sadenosyl homocysteine hydrolase sahh activity in red cells and elevated amounts of deoxyadenosine in urine. There has been concern about its usefulness in immunocompromised patients, especially hiv positive patients with very low cd4 counts. Carretero sastre jl, martanez barredo f, alonso mallo e et al. Adenosine deaminase also known as adenosine aminohydrolase, or ada is an enzyme ec 3. Therefore evaluation of new fast and low cost diagnostics tools seems a good strategy in order to allow a specific treatment. Tuberculosis 24 tuberculosis tb is an infectious disease that is acquired by inhaling the bacteria that cause the disease.
Health care resources for this disease expert centres diagnostic tests 46 patient organisations 36 orphan drug s deaminssa me peacock 1 estimated hindex. Department of health and human services, cdc, october 2012. Diagnostic value of serum adenosine deaminase level in pulmonary. Adenosine deaminase ada has been developed and widely used for the diagnosis of tb. Pdf adenosin deaminasa ada en liquido cefalorraquideo. Adenosina deaminasa en lcr en pacientes vih y enfermedades. Adenosine deaminase, tuberculosis, pleural effusion background tuberculous pleural effusion tpe is a main cause of pleural effusion 1. About 90 percent of those who become infected show no sign of disease latent infection, but harbor the organism and have a risk of developing active tb later. Role of adenosine deaminase estimation in differentiation. Veinte pacientes tuvieron tuberculosis pleural, 7 tenian neoplasia y 5 otra causa. Pdf use of adenosine deaminase for the diagnosis of. The purpose of this study is to assess the ada levels in nontuberculous lymphocytic pleural effusions lymphocyte countw50% of different aetiologies. Use of adenosine deaminase for the diagnosis of tuberculosis. Background adenosine deaminase activity ada is a commonly used marker for the diagnosis of tuberculous pleural effusion.
In one study, 20 a high level of adenosine deaminase greater than 47 u per l nkat per l was seen in 99 percent of tuberculous effusions. The symptoms and signs are often insidious and nonspecific. Severe combined immunodeficiency scid due to adenosine deaminase ada deficiency is a form of scid characterized by profound. Very high level of adenosin deaminasa ada in pleural. The adenosine deaminase test may be used to help determine whether a person has a mycobacterium tuberculosis infection tb of the lining. Accinelli r, yi a, calderon a, villaran c y carcelen a. Chapter 2 transmission and pathogenesis of tuberculosis. The goal of this study is to assess the diagnostic value of serum ada levels in pulmonary tb patients. For all other comments, please send your remarks via contact us.
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