Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
6115629 | Diagnostic Microbiology and Infectious Disease | 2016 | 29 Pages |
Abstract
Adenosine deaminase (ADA) activity measurement in pleural fluid is a relevant test to diagnose pleural tuberculosis (pTB) in high tuberculosis prevalence settings. We investigated the diagnostic utility of pleural ADA using a retrospective analysis of patients admitted with newly diagnosed pleural effusion without identified etiology between 2001 and 2008 in Paris suburb, a low to medium tuberculosis prevalence area. 104 adults (mean age 55 years; 34 with pTB, 70 with other diagnoses) were analyzed. Median follow-up was 15.6 months. Mean [interquartile range] pleural ADA was 119 U/L [IQR: 83-143] in pTB and 24 U/L [IQR: 15-31] in non-tuberculous effusions (PÂ <Â 0.001). With an optimal pleural ADA cut-off value of 41.5 U/L for pTB diagnosis, sensitivity and specificity were 97.1% and 92.9%, while positive and negative predictive values were 86.8% and 98.5%, respectively. We conclude that pleural ADA activity could be integrated in the diagnostic procedures of pTB in low to medium tuberculosis prevalence settings.
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Authors
Jean-Marie Michot, Yoann Madec, Sophie Bulifon, Cécile Thorette-Tcherniak, Nicolas Fortineau, Nicolas Noël, Olivier Lambotte, Younes El Jahiri, Hervé Delacour, Jean-François Delfraissy, François-Xavier Blanc,