Abstract

This study was done to investigate the course of serum adenosine deaminase (sADA) levels at the beginning of and during the treatment and its relationship with clinical, radiological, and laboratory parameters in pulmonary tuberculosis (TB) patients. Levels of sADA were measured at the time of diagnosis (at the beginning), and in the 1st, 2nd, and 6th (at the end of treatment) months in 38 smear positive TB patients. Chest roentgenograms were taken. Additionally, peripheral blood leukocyte and lymphocyte counts, erythrocyte sedimentation rates (ESR), and C reactive protein (CRP) levels were measured. As a control group, 15 healthy cases were enrolled into the study. Mean level of sADA at the beginning was 33.2±13.9 U/L in the patient group and 19.0±7.1 U/L in control cases. The specificity and sensitivity were found as 100%, 42%, respectively. Mean level of sADA increased to 45.1±10.6 U/L in the first month and gradually decreased to 34.6±10.1 U/L in the 2nd month and to 24.6±4.7 U/L in the 6th month. In the analysis of those parameters with ANOVA test (post hoc Bonferroni), a significant difference was found between the baseline and the 1st month sADA levels (p=0.005). A significant difference was also found between the 1st and 2nd month sADA levels (p=0.016), and between the 1st month and the end of treatment sADA levels (p<0.001). The difference between sADA levels of the patients at the end of treatment and levels of the control group was still significant (p=0.01). Within the same period, there were significant differences between the radiological course, the count of peripheral blood lymphocytes, ESR and CRP levels of the patients. In conclusion, sADA levels in TB patients show a slight elevation in the first month but decrease during the treatment course in parallel with the efficacy of the treatment. We think that sADA levels might have an association with lymphocytic activation.