Abstract

Twenty percent of patients of pleural effusion have no diagnosis with classical methods. We aimed to investigate diagnostic value of ADA, which is applied easily, and noninvasive method for tuberculous pleural effusion. The pleural effusions of 121 patients were diagnosed in SSK Süreyyapafla Hospital and SSK Göztepe Hospital in between June 2000 and January 2001. The cases were designated as tuberculosis or nontuberculosis group. ADA and isoenziyms were determined by the colorimetric method described by Giusti and Galanti. We have 121 patients who were 22 women and 99 men. Their ages are between 16 and 84 mean was 51.7±16.9. Thirty patients were tuberculosis. The differences of two groups were statistically significant for total ADA, ADA1 and ADA2 (p<0.05). The sensitivities of total ADA, ADA1 and ADA2 activities for tuberculosis were 93, 90, 87% respectively; their specificities were 95, 95, 96% respectively; their positive predictive values were 88, 87, 89% respectively; their negative predictive values were 98, 96, 89% respectively in pleural effusion. The sensitivities of total ADA, ADA1 and ADA2 activities for tuberculosis were 80, 77, and 77% respectively; their specificities were 43, 31, 48% respectively; their positive predictive values were 41, 29, 35% respectively; their negative predictive values were 85, 78, 85% respectively in serum. Isoenzyms of ADA have not more contributed than total ADA for diagnosis. This study shown that value of total ADA and isoenzymes may help to differentiate for diagnosis of tuberculosis pleural effusion. In contrast, total ADA value in serum has no value for diagnosis.