COVID-19 Update - This is to inform you that the Government of India has announced a complete lockdown in India 22nd March 2020 to 14th April 2020. As a result, our offices will now be closed till 14th April 2020 and all our employees will be working from home. Office telephones will not be answered, and therefore you are requested to direct all your queries related to manuscript submission, review process, publication etc. at below mentioned details. editor@innovativepublication.com, rakesh.its@gmail.com, Mob. 8826373757, 8826859373, 9910947804

Article view: 326

Article download: 116

IP Indian Journal of Immunology and Respiratory Medicine


To assess diagnostic utility of pleural fluid adenosine deaminase (ADA), interferon gamma (IFN), lymphocyte/neutrophil ratio (L/N) and its combination in differentiating tubercular and non-tubercular exudative pleural effusion


Full Text PDF Share on Facebook Share on Twitter


Author Details : Varuna Jethani*, Girish Sindhwani, Vinit Mehrotra, Aarti Kotwal

Volume : 4, Issue : 1, Year : 2019

Article Page : 68-72


Suggest article by email

Abstract

Background: One of the common extrapulmonary manifestation of tuberculosis (TB) is pleural effusion. The conventional culture suffers from lack of sensitivity. Many pleural fluid markers have been evaluated but none has been proved to be ideal in diagnosing tubercular pleural effusion. We have studied Adenosine deaminase (ADA), Interferon gamma (IFN), lymphocyte/neutrophil (L/N) ratio and their combination for diagnosis of tubercular pleural effusion.
Methodology: All consecutive patients with pleural effusion were subjected to thoracentesis and segregated into transudative and exudative using Light`s criteria. Patients with exudative pleural effusion were enrolled and divided into two groups. Group-I comprised of patients with tubercular etiology, Group-II- non-tubercular etiology. 45 patients were selected for each group. ADA, IFN, L/N ratio in pleural fluid of these patients were measured. The sensitivity, specificity and predictive values were calculated.
Results: The sensitivity, specificity, positive predictive value, negative predictive value of ADA, IFN, L/N ratio were 88.89%, 99.85%, 86.96%, 99.87%; 97.78%, 97.78%, 97.78%, 97.78%; 88.89%,17.78%, 51.95%, 61.54%  respectively. Combination of ADA, IFN, L/N ratio provided the highest specificity that is 100%.
Conclusions: Pleural fluid ADA, IFN were found to be useful in differentiating tubercular from non-tubercular patients. Combination of ADA, IFN, L/N was found to be most beneficial.

Keywords: ADA; sExtrapulmonary tuberculosis; Pleural effusion.

Doi : 10.18231/2581-4222.2019.0015

How to cite : Jethani V, Sindhwani G, Mehrotra V, Kotwal A, To assess diagnostic utility of pleural fluid adenosine deaminase (ADA), interferon gamma (IFN), lymphocyte/neutrophil ratio (L/N) and its combination in differentiating tubercular and non-tubercular exudative pleural effusion. IP Indian J Immunol Respir Med 2019;4(1):68-72

Copyright © 2019 by author(s) and IP Indian J Immunol Respir Med. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) (creativecommons.org)