Adenosine deaminase is a useful biomarker to diagnose pleural tuberculosis in low to medium prevalence settings

作者：Michot Jean Marie; Madec Yoann; Bulifon Sophie; Thorette Tcherniak Cecile; Fortineau Nicolas; Noel Nicolas; Lambotte Olivier; El Jahiri Younes; Delacour Herve; Delfraissy Jean Francois; Blanc Francois Xavier^*

来源：Diagnostic Microbiology and Infectious Disease, 2016, 84(3): 215-220.

DOI：10.1016/j.diagmicrobio.2015.11.007

• Mycobacterium tuberculosis
• Pleural effusion
• Biological marker

Adenosine deaminase (ADA) activity measurement in pleural fluid is a relevant test to diagnose pleural tuberculosis (pTB) in high tuberculosis prevalence settings. We investigated the diagnostic utility of pleural ADA using a retrospective analysis of patients admitted with newly diagnosed pleural effusion without identified etiology between 2001 and 2008 in Paris suburb, a low to medium tuberculosis prevalence area. 104 adults (mean age 55 years; 34 with pTB, 70 with other diagnoses) were analyzed. Median follow-up was 15.6 months. Mean [inter quartile range] pleural ADA was 119 U/L [IQR: 83-143] in pTB and 24 U/L [IQR: 15-31] in non-tuberculous effusions (P < 0.001). With an optimal pleural ADA cut-off value of 41.5 U/L for pTB diagnosis, sensitivity and specificity were 97.1% and 92.9%, while positive and negative predictive values were 86.8% and 98.5%, respectively. We conclude that pleural ADA activity could be integrated in the diagnostic procedures of pTB in low to medium tuberculosis prevalence settings.

• 出版日期2016-3