Evaluation of the use of Ascitic fluid Adenosine Deaminase activity in the diagnosis of Tuberculous Ascites

DR. RADHIKA KRISHNASWAMY; Shyam Narayan; Priyadharshini K

Volume : V, Issue : IX, September - 2016

Evaluation of the use of Ascitic fluid Adenosine Deaminase activity in the diagnosis of Tuberculous Ascites

Dr. Radhika Krishnaswamy, Shyam Narayan, Priyadharshini K

Abstract :

BACKGROUND : ADA is found to be a very useful test for early detection of extra pulmonary tuberculosis such as tubercular pleural effusion and tuberculous ascites. The present study was undertaken to evaluate the diagnostic accuracy of a cut off point of 30 U/L of ADA in ascitic fluid for the diagnosis of abdominal tuberculosis by determining the sensitivity and specificity. MATERIALS AND METHODS : The study was carried out on 78 patients suffering from the ascites who were admitted in a tertiary care center in Bangalore. The patients were divided into tubercular ascites and non tubercular ascites group on the basis of detailed clinical history, physical examination, bacteriological tests(AFB),radiological investigation ( abdominal scan, USG); ADA was analyzed in both groups. ADA analysis was done in ascitic fluid by the colorimetric procedure of GALANTI AND GIUSTI method employing reagents optimized by Kaplan. RESULT: In tuberculous ascites group the mean level of ADA was 43.48u/l. In Non tuberculous ascites the mean level is 9.32U/L (p<0.001, strongly significant) The sensitivity and specificity were 86.80% and 97.5% and positive and negative predictive values were of 97% and 88.6% respectively and an accuracy of 92.3 with a cutoff point of 30U/L CONCLUSION:- The present study, shows that ADA with a cut off value of 30U/L is useful biochemical marker and can very well be utilized for the diagnosis of tubercular ascites.