الفهرس 
Adenosine Deaminase and Tuberculosis
Tuberculous pericardial effusionOnly 14 pages are availabe for public view
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Abstract
Tuberculosis remains one of the major health problems in the world with more than 7 million new cases and 3 million deaths each year (Murray et al., 1990).
The objective of this study was to evaluate the diagnostic value of serum adenosine deaminase level in active pulmonary TB.
The study was conducted on sixty persons, fifty patients admitted to Abassia chest hospital and chest department, Ain Shams University hospital and ten normal persons.
Those were classified into (5) groups:-
o Group(1) twenty patients with sputum positive for AFB (newly diagnosed and not on anti-tuberculous treatment).
o Group(2) ten patients with bronchogenic carcinoma diagnosed clinically, radiologically, and histopathologically.
o Group(3) ten patients with pneumonia diagnosed clinically, radiologically, and bacteriologically.
o Group(4) ten patients with old pulmonary TB.
o Group(5) ten normal healthy persons.
All subjected to :-
Full history taking.
Through clinical general and local chest examination.
Plain chest X-ray.
Sputum Ziehl Neelsen stain.(for three times)
Routine lab investigation.
Tuberculin test.
Measurement of ADA activity in the serum.
CT scan in selected cases.
The results of this study showed that out of the 60 persons 48 (80%) were males and 12 (20%) were females. Their age ranged from 18-67 years.
The most prevalent complaints among group (1) were cough and expectoration as it were found in 100% of them. And the least complaint was heamoptysis ( in 35% of them ), but in group (2) the most prevalent complaint was cough ( in 100%) followed by expectoration (in 90%) , and the least complaints was fever and toxemia (in 0 %), in group (3) cough and expectoration were the most prevalent complaints ( in 100 %) and toxemia was the least ( non of them), in group (4) cough was the most prevalent one(in all of them) followed by dyspnea (in 90% ).
Serum level of ADA was evaluated in all subjects and was (25.4 - 60.3) U/L with mean ± SD 43.6 ± 13 in patients with active pulmonary TB, and was (14.6 – 37.2) U/L with mean ± SD 23.8 ± 7.8 in patients with bronchogenic carcinoma, and was (12.1 – 37.1) U/L with mean ± SD 23 ± 8.8 in patients with pneumonia, and was (12.4-35.7) U/L with mean ± SD 22.6 ± 3.6 in patients with old pulmonary TB, and was (12.1-31.2) U/L with mean ± SD 23 ± 7 in normal group.
The cutoff point obtained by the ROC ( receiver operator characteristic) curve method for serum ADA was 30 U/L.
Serum ADA sensitivity and specificity at this cutoff point were 85%, 100% respectively with a positive predicted value 100% and accuracy of 62%.
In the present study the relationship between serum ADA level and ESR was evaluated. It was statistically significant and positively correlated among active pulmonary TB group only.
The present work showed that the relation between serum ADA activity and leukocytic count or lymphocytic count was insignificant statistically.
The results of this study showed that serum ADA levels were statistically significantly increased in patients with active pulmonary TB when compared to patients with pneumonia, bronchogenic carcinoma, old pulmonary TB, or normal subjects.