MYCOBACTERIUM TUBERCULOSIS DETECTION IN PLEURAL EFFUSION BY ADENOSINE DEAMINASE ASSAYMANOJ KUMAR, REEMA SHARMA, MANJUSHREE DUBEY, NAHEED BANU AND SADHANA SHARMAAbstract Tuberculosis, caused by Mycobacterium tuberculosis, is the commonest health problem worldwide. It is conclusively diagnosed on the basis of the presence of Mycobacterium in body fluids. Routine investigations for the detection of the disease are many times falsely negative or positive as Mycobacterium is not easily detectable. Newer investigations have shown adenosine deaminase enzyme (ADA), a new marker for the disease. Current study was aimed to confirm the correlation between increased ADA levels in pleural fluid of patients who have been diagnosed with tuberculosis. The study was conducted at Narinder Mohan Hospital and Research Centre, Ghaziabad, India. 83 patients (57 males and 26 females, from age group 15-78 years) were screened for pleural effusion, out of which 67 were tuberculous and 16 non-tuberculous. The ADA levels of these samples were measured along with ELISA, culture and other routine investigations. In all 67 patients belonging to tuberculous group, the ADA levels were above 40U/L with a mean value of 115.71±35.00, whereas in non-tuberculous group only two cases were above 40U/L with a mean value of 26.73±10.11. Reference values used for ADA levels in pleural fluid were - Normal: <40U/L; Suspect: 40-60 U/L and Positive: >60 U/L. The test was found to be significantly specific and sensitive even at higher cut off value. Raised levels of ADA in the pleural fluid are a suggestive marker for Mycobacterium presence in pleural effusion.
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