ADENOSINE DEAMINASE ACTIVITY IN PERICARDIAL EFFUSION

Objective: To test the efficacy of enzyme Adenosine Deaminase (ADA) in the early and rapid diagnosis of tuberculous pericarditis presenting as moderate and large pericardial effusions.Material and Methods: The study was conducted at Lady Reading Hospital, Peshawar, from 1998 to 2000. Cases of moderate and large pericardial effusions were studied for ADA estimation. ADA activity was tested in four groups, Group A cases met the standard criteria of diagnosing tuberculosis, Group B included cases having high degree of suspicion of tuberculosis, Group C included cases having other etiologies except tuberculosis and Group D included the controls.Results: Out of 102 cases of pericardial effusion. ADA estimation was done in 84 cases: Group A, 31 cases: Group B, 21 cases: Group C, 17 cases & Group D, 15 cases.ADA levels in Group A were mean 93+ 21, Group B 84+16, Group C 51 + 12 and Group D 26+14.The Group A and B were having levels much above the cutoff range. The presence of high enzyme activity in Group C above the cutoff range limited its utility as a specific marker for TB. When combined Group A and B were compared against Group C and D. only then the difference reached to the level of statically significance making ADA a sensitive marker for TB.Conclusion: ADA can be used as sensitive marker for the diagnosis of tuberculous activity however other large studies are further needed to test its efficacy in our setup.