Role of Adenosine Deaminase in Pleural Fluid Evaluation

Today at Parkland Morning Report, we talked about the utility of adenosine deaminase (ADA) in evaluating a patient with a pleural effusion, especially if there is a concern for tuberculosis. The link below is an article from The Journal of Clinical Medicine Research, titled “Role of Adenosine Deaminase Estimation in Differentiation of Tuberculous and Non-tuberculous Exudative Pleural Effusions.”

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140883/pdf/jocmr-02-79.pdf

Key points from the article:

  • The authors looked at pleural fluid from 96 samples, divided into tuberculous (56 samples) and non-tuberculous groups (40 samples).
  • All of the samples met Light’s Criteria to be considered an exudative effusion.
  • All 56 samples from the tuberculous group had positive ADA test (>40 U/L). Only one sample from the non-tuberculous group had a positive ADA test.
  • Authors conclude that ADA pleural fluid levels can play an important rule in differentiating tuberculous pleural effusions.
  • ADA is considered to be a low cost test with rapid turnover.