Please use this identifier to cite or link to this item: https://doi.org/10.1186/1471-2334-13-546
Title: Factors affecting pleural fluid adenosine deaminase level and the implication on the diagnosis of tuberculous pleural effusion: A retrospective cohort study
Authors: Tay, T.R
Tee, A 
Keywords: adenosine deaminase
lactate dehydrogenase
adenosine deaminase
biological marker
adult
area under the curve
article
blood cell count
cohort analysis
correlation coefficient
demography
diagnostic test accuracy study
diagnostic value
female
groups by age
human
human cell
lymphocyte count
major clinical study
male
pleura effusion
pleura fluid
predictive value
receiver operating characteristic
retrospective study
sensitivity and specificity
tuberculous pleural effusion
aged
enzymology
exudate
metabolism
middle aged
pleura effusion
tuberculous pleurisy
Adenosine Deaminase
Adult
Aged
Biological Markers
Exudates and Transudates
Female
Humans
Male
Middle Aged
Pleural Effusion
Retrospective Studies
Sensitivity and Specificity
Tuberculosis, Pleural
Issue Date: 2013
Citation: Tay, T.R, Tee, A (2013). Factors affecting pleural fluid adenosine deaminase level and the implication on the diagnosis of tuberculous pleural effusion: A retrospective cohort study. BMC Infectious Diseases 13 (1) : 546. ScholarBank@NUS Repository. https://doi.org/10.1186/1471-2334-13-546
Rights: Attribution 4.0 International
Abstract: Background: Adenosine deaminase (ADA) is useful in the diagnosis of tuberculous pleural effusion (TPE). This study aims to determine the factors affecting pleural fluid ADA levels and to establish the optimal ADA levels for diagnosis of TPE for different age groups.Methods: This was a retrospective study from January 2007 to October 2011. One hundred and sixty patients who had pleural fluid ADA performed for investigation of pleural effusion were analyzed. Variables examined included demographics, pleural fluid characteristics and peripheral blood counts. The ADA cut-offs according to age were selected using the receiver operating characteristic (ROC) curve.Results: The mean pleural fluid ADA was significantly higher in the TPE group (100 ± 35 IU/L) compared to non TPE patients (30 ± 37 IU/L). There was significant correlation between pleural fluid ADA and age, pleural fluid protein, LDH, and fluid absolute lymphocyte count. The strongest correlation was seen with age (r = -0.621). For patients ? 55 years old the ROC for ADA had area under curve (AUC) of 0.887. A pleural fluid ADA of 72 IU/L had sensitivity of 95.1%, specificity of 87.5%, positive predictive value (PPV) of 95.1% and negative predictive value (NPV) of 87.5% for the diagnosis of TPE. For patients > 55 years old the AUC is 0.959. ADA of 26 IU/L had a sensitivity of 94.7%, specificity of 80.4%, PPV of 62% and NPV of 97.8%.Conclusions: There is a significant negative correlation between pleural fluid ADA and age. For older patients, a lower ADA cut-off should be used to exclude TPE. © 2013 Tay and Tee; licensee BioMed Central Ltd.
Source Title: BMC Infectious Diseases
URI: https://scholarbank.nus.edu.sg/handle/10635/181540
ISSN: 14712334
DOI: 10.1186/1471-2334-13-546
Rights: Attribution 4.0 International
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