The value of adenosine deaminase (ADA) determination in the diagnosis of tuberculous ascites Valor da determinação da adenosina deaminase (ADA) no diagnóstico da ascite tuberculosa

• Published in: Revista do Instituto de Medicina Tropical de São Paulo
• Main Authors: Cesar Q. Brant, Mario R. Silva Jr., Erica P. Macedo, Claudio Vasconcelos, Natalina Tamaki, M. Lucia G. Ferraz
• Format: Article in Journal/Newspaper
• Language: English
• Published: Universidade de São Paulo (USP) 1995
• Subjects: Tuberculous peritonitis; Adenosine deaminase; Ascites; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1590/S0036-46651995000500011; https://doaj.org/article/e03041d832ae4502b3bf483cc2fe9f5b

In order to evaluate the role of the determination of adenosine deaminase activity (ADA) in ascitic fluid for the diagnosis of tuberculosis, 44 patients were studied. Based on biochemical, cytological, histopathological and microbiological tests, the patients were divided into 5 groups: G1 - tuberculous ascites (n = 8); G2 - malignant ascites (n = 13); G3 - spontaneous bacterial peritonitis (n = 6); G4 - pancreatic ascites (n = 2); G5 - miscelaneous ascites (n = 15). ADA concentration were significantly higher in G1 (133.50 ± 24.74 U/l) compared to the other groups (G2 = 41.85 ± 52.07 U/l; G3 = 10.63 ± 5.87 U/l; G4 = 18.00 ± 7.07 U/l; G5 = 11.23 ± 7.66 U/l). At a cut-off value of >31 U/l, the sensitivity, specificity and positive and negative preditive values were 100%, 92%, 72% and 100%, respectively. ADA concentrations as high as in tuberculous ascites were only found in two malignant ascites caused by lymphoma. We conclude that ADA determination in ascitic fluid is a useful and reliable screening test for diagnosing tuberculous ascites. Values of ADA higher than 31 U/l indicate more invasive methods to confirm the diagnosis of tuberculosis. Com o objetivo de avaliar o papel da determinação da atividade da enzima adenosina deaminase (ADA) no diagnóstico da peritonite tuberculosa, foram estudados 44 pacientes. De acordo com os resultados das determinações bioquímicas, citológicas, histopatológicas e microbiológicas, os pacientes foram divididos nos seguintes grupos: G1 - ascite tuberculosa (n = 8); G2 - neoplásica (n = 13), G3 - peritonite bacteriana espontânea (n = 6), G4 -ascite pancreática (n = 2), G5 - miscelânea (n = 15). A concentração de ADA no grupo de pacientes com peritonite tuberculosa foi de 133.50 ± 24.74 U/l, significantemente mais elevada que nos outros grupos (G2 = 41.85 ± 52.07; G3 = 10.63 ± 5.87; G4 = 18.00 ± 7.07; G5 = 11.23 ± 7.66). Com um limite de corte de 31 U/l, a sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo para diagnóstico de tuberculose foram, ...