Repeatability of pleural adenosine deaminase measurements in diagnostic evaluation of pleural effusions
Date
2018Language
en
Keyword
Abstract
Background: A follow-up thoracentesis is proposed in suspected atypical tuberculosis cases. The study aimed to define the variability of pleural ADA values across repeated thoracenteses in different types of pleural effusions (PEs) and to evaluate whether ADA variance, in regard to the cutoff value of 40 U/L, affected final diagnosis. Methods: A total of 131 patients with PEs of various etiologies underwent three repeated thoracenteses. ADA values were subsequently estimated. Results: 82% and 55% of patients had greater than 10% and 20% deviation from the highest ADA value, respectively. From those patients who had a variance of 20%, 36% had only increasing ADA values, while 19% had only decreasing values. Considering the cutoff value of 40 U/L, only in two cases, ADA decreased below this threshold, which concerned a man with tuberculous pleurisy and a woman with lymphoma both in the course of treatment. Furthermore, only in two cases with rising values, ADA finally exceeded the cutoff limit, which concerned a man with rheumatoid pleurisy and a man with tuberculous pleurisy. Surprisingly, malignant PEs (MPEs) showed a higher percentage of increasing values compared to all other exudates that did not, however, exceed the threshold. Conclusion: The determination of pleural ADA levels is a reproducible method for rapid tuberculosis diagnosis. The detected measurement deviations do not appear to affect final diagnosis. In specific situations, repeated ADA measurements may be valuable in directing further diagnostic evaluation. More investigation is needed to elucidate the possible prognostic significance of the increasing trend in ADA values in MPEs. © 2017 Wiley Periodicals, Inc.
Collections
Related items
Showing items related by title, author, creator and subject.
-
Hyaluronic acid levels are increased in complicated parapneumonic pleural effusions
Zaga, T.; Makris, D.; Tsilioni, I.; Kiropoulos, T.; Oikonomidi, S.; Damianos, A.; Gourgoulianis, K. I. (2011)Background and Aim. Hyaluronic acid (HA) is a component of extracellular matrix and may play a role in the pleural inflammation which is implicated in parapneumonic effusions.The aim of the current study was to investigate ... -
Discrimination of exudative pleural effusions based on pleural adenosine deaminase (Ada)-c-reactive protein (crp) levels, and their combination: An observational prospective study
Perlepe G., Varsamas C., Petinaki E., Antonopoulos D., Daniil Z., Gourgoulianis K.I. (2021)(1) Background: Malignant (MPE), parapneumonic (PPE) and tuberculous (TPE) pleural effusions constitute common causes of pleurisy. Discriminating among them is usually challenging. C-reactive protein (CRP) and adenosine ... -
Pleural effusion osmolality correlation with pH and glucose level of pleural fluid and its effects on the pleural membrane permeability
Peppa V.-G., Solenov E.I., Kalomenidis I., Tsilioni I., Gourgoulianis K.I., Hatzoglou C., Zarogiannis S.G. (2021)Background and aim: Pleural effusions (PE) are a common clinical entity resulting from pathologies that affect the pleural space such as congestive heart failure, malignancy and pneumonia. The osmolality of the pleural ...