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Journal of Indian Association of Pediatric Surgeons
     Journal of Indian Association of Pediatric Surgeons
Official journal of the Indian Association of Pediatric Surgeons         
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Year : 2001  |  Volume : 6  |  Issue : 4  |  Page : 125-129

Role of pleural fluid adenosine deaminase estimation for the diagnosis of tuberculosis in pediatric surgical patients with suppurative thoracic lesions


Department of Pediatric Surgery, T N Medical College & B Y L Nair Charitable Hospital Mumbai-400008

Correspondence Address:
P Mane
Department of Pediatric Surgery, T N Medical College & B Y L Nair Charitable Hospital Mumbai-400008

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ABSTRACT: Adenosine deaminase (ADA) is an enzyme of purine metabolism that catalyses hydrolytic and irreversible deamination of deoxyadenosine and adenosine to deoxyadenosine and adenosine respectively. Lymphocytic proliferation and differentiation requires ADA. The levels of ADA rise incases of tuberculosis. We studied the role of pleural fluid ADA estimation to detect tuberculosis in pediatric patients presenting with suppurative thoracic lesions. Thirty six patients with suppurative thoracic lesions who underwent surgery form June 1999 to July 2001 were included in the study. The age group was between 1.5 years to 9 years. The suppurative thoracic lesions included empyema thoracis, bronchiectasis, lung abscess and tubercular lobe destruction. Pleural fluid of all these patients was quantitatively assessed for ADA levels. Biopsies of pleura and lung were done in all patients. Pleural fluid ADA levels above 40IU/L was taken as suggestive of tuberculosis. Histopathological proof of tuberculosis was sought in all the patients. Sensitivity of ADA to detect tuberculosis was 88.2 percent, specificity was 89.5 percent, positive predictive value was 88.2 percent and negative predictive value was 89.5 percent.






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