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ADA pleural effusion

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https://www.readbyqxmd.com/read/29218743/repeatability-of-pleural-adenosine-deaminase-measurements-in-diagnostic-evaluation-of-pleural-effusions
#1
Ourania S Kotsiou, Panagiota Tzortzi, Rafailia A A Beta, Athanasios Kyritsis, Konstantinos I Gourgoulianis
BACKGROUND: A follow-up thoracentesis is proposed in suspected atypical tuberculosis cases. The study aimed to define the variability of pleural ADA values across repeated thoracenteses in different types of pleural effusions (PEs) and to evaluate whether ADA variance, in regard to the cutoff value of 40 U/L, affected final diagnosis. METHODS: A total of 131 patients with PEs of various etiologies underwent three repeated thoracenteses. ADA values were subsequently estimated...
December 7, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/29208371/integrated-semi-targeted-metabolomics-analysis-reveals-distinct-metabolic-dysregulation-in-pleural-effusion-caused-by-tuberculosis-and-malignancy
#2
Nanying Che, Yan Ma, Huabin Ruan, Lina Xu, Xueying Wang, Xinting Yang, Xiaohui Liu
BACKGROUND: Tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE) are the 2 most frequent causes of exudative pleural effusions (PEs). However, the clinical differentiation is challenging. METHODS: Metabolic signatures in pleural effusion from 156 patients were profiled. An integrated semi-targeted metabolomics platform was incorporated for high throughput metabolite identification and quantitation. In this platform, orbitrap based mass spectrometry with data dependent MS/MS acquisition was applied in the analysis...
December 2, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29202740/the-pleural-fluid-lactate-dehydrogenase-adenosine-deaminase-ratio-differentiates-between-tuberculous-and-parapneumonic-pleural-effusions
#3
Jinlin Wang, Jun Liu, Xiaohong Xie, Panxiao Shen, Jianxing He, Yunxiang Zeng
BACKGROUND: Although pleural fluid lactate dehydrogenase (LDH) and adenosine deaminase (ADA) levels are often used to distinguish between tuberculous pleural effusion (TPE) and parapneumonic pleural effusion (PPE), this can be challenging as the LDH level may vary from normal to severely increased in PPE and a significantly elevated ADA is frequently measured in both conditions. In this study, we evaluated use of the pleural fluid LDH/ADA ratio as a new parameter to discriminate TPE from PPE...
December 4, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29021481/cryptococcal-pleuritis-presenting-with-lymphocyte-predominant-and-high-levels-of-adenosine-deaminase-in-pleural-effusions-coincident-with-pulmonary-tuberculosis
#4
Yoshitomo Kushima, Hidenori Takizawa, Yasutaka Machida, Takafumi Umetsu, Naoya Ikeda, Masaaki Miyoshi, Kazuyuki Chibana, Yasuo Shimizu, Akihiro Takemasa, Yoshiki Ishii
Co-infection with cryptococcus and tuberculosis has rarely been reported. We herein report a case of an 80-year-old man with cryptococcal pleuritis concurrent with pulmonary tuberculosis. He was admitted for progression of left pleural effusion and consolidation in the left upper lobe. Culture for Mycobacterium tuberculosis was positive in sputum, and analyses of pleural effusion revealed lymphocyte-predominant high levels of adenosine deaminase (ADA). Medical thoracoscopy revealed massive infiltration of Cryptococcus neoformans in pleura without granuloma...
October 11, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28864369/predictive-factors-and-treatment-outcomes-of-tuberculous-pleural-effusion-in-patients-with-cancer-and-pleural-effusion
#5
Jaehee Lee, Yong Dae Lee, Jae Kwang Lim, Deok Heon Lee, Seung Soo Yoo, Shin Yup Lee, Seung Ick Cha, Jae Yong Park, Chang Ho Kim
BACKGROUND: Patients with cancer are at an increased risk of tuberculosis. As pleural effusion has great clinical significance in patients with cancer, the differential diagnosis between tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE) is important. However, the predictive factors and treatment outcomes of TPE in patients with cancer have rarely been studied. MATERIALS AND METHODS: Confirmed TPE cases identified at cancer diagnosis and during anticancer management from 2008-2015 were retrospectively investigated...
August 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28799302/clinical-profile-of-patients-presenting-with-malignant-pleural-effusion-to-a-tertiary-health-care-centre
#6
Nitin Gadewad, Kunal Deokar, Shivhari Ghorpade
BACKGROUND: Malignant pleural effusions are one of the leading causes of exudative pleural effusions. We studied the clinical profile of patients presenting with malignant pleural effusion, their cytological and histopathological features and the efficacy of pleurodesis in preventing recurrence. MATERIALS AND METHODS: 100 patients who were positive for malignant cells in pleural fluid cytology or pleural biopsy were recruited. After history and clinical examination, Chest radiographs, Computed tomography of chest were performed...
August 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28728264/-exploratory-research-on-diagnostic-essentials-of-pediatric-tuberculous-pleurisy
#7
H Xu, J R Liu, S Y Zhao
Objective: To summarize the clinical diagnostic essentials of pediatric tuberculous pleurisy so as to reduce the misdiagnosis rate. Method: A retrospective study was conducted on 113 cases of tuberculous pleurisy who were seen from August 2006 to September 2014 in the second Department of Respiratory Medicine, Beijing Children's Hospital Affiliated to Capital Medical University. Meanwhile, another 113 cases of children over 5 years of age with mycoplasma pneumoniae pneumonia complicated with pleural effusion were randomly selected as control group...
July 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28727272/performance-of-clinical-prediction-rules-for-diagnosis-of-pleural-tuberculosis-in-a-high-incidence-setting
#8
Lely Solari, Alonso Soto, Patrick Van der Stuyft
OBJECTIVES: Diagnosis of pleural tuberculosis (PT) is still a challenge, particularly in resource-constrained settings. Alternative diagnostic tools are needed. We aimed at evaluating the utility of Clinical Prediction Rules (CPRs) for diagnosis of pleural tuberculosis in Peru. METHODS: We identified CPRs for diagnosis of PT through a structured literature search. CPRs using high-complexity tests, as defined by the FDA, were excluded. We applied the identified CPRs to patients with pleural exudates attending two third-level hospitals in Lima, Peru, a setting with high incidence of tuberculosis...
October 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28648009/-diagnostic-performance-of-t-spot-tb-on-peripheral-blood-in-combination-with-adenosine-deaminase-on-pleural-fluid-for-the-diagnosis-of-tuberculous-pleurisy-within-different-age-group
#9
H Y Xu, D Q Zhang, J R Ye, S S Su, Y P Xie, C S Chen, Y P Li
Objective: To evaluate the performance of T cell enzyme-linked immuno-spot assay (T-SPOT) on peripheral blood in combination with adenosine deaminase (ADA) on pleural fluid for diagnosis of tuberculous (TB) pleurisy within different age groups. Methods: The data of patients with pleural effusion from the Department of Pulmonary and Critical Care Medicine of the First Affiliated Hospital of Wenzhou Medical University from April 2012 to November 2016 were retrospectively analyzed, and the diagnoses of these patients were histopathologically confirmed through medical thoracoscopy...
June 27, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28545517/evaluation-of-two-strategies-for-the-interpretation-of-tumour-markers-in-pleural-effusions
#10
Jaume Trapé, Francesc Sant, Josefina Franquesa, Jesús Montesinos, Anna Arnau, Maria Sala, Oscar Bernadich, Esperanza Martín, Damià Perich, Concha Pérez, Joan Lopez, Sandra Ros, Enrique Esteve, Rafael Pérez, Jordi Aligué, Gabriel Gurt, Silvia Catot, Montserrat Domenech, Joan Bosch, Josep Miquel Badal, Mariona Bonet, Rafael Molina, Josep Ordeig
BACKGROUND: Pleural effusions present a diagnostic challenge. Approximately 20% are associated with cancer and some 50% require invasive procedures to perform diagnosis. Determination of tumour markers may help to identify patients with malignant effusions. Two strategies are used to obtain high specificity in the differential diagnosis of malignant pleural effusions: a) high cut-off, and b) fluid/serum (F/S) ratio and low cut-off. The aim of this study is to compare these two strategies and to establish whether the identification of possible false positives using benign biomarkers - ADA, CRP and % of polymorphonuclear cells - improves diagnostic accuracy...
May 25, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28494727/expression-of-toll-like-receptor-2-and-toll-like-receptor-4-in-tuberculous-pleural-effusion
#11
Yingzhong Lin, Tingmei Feng, Jiao Lan, Chunxia Chen, Zhiqiang Qin, Yanbin Wu, Huanzhong Shi, Jianbo Ye, Caizhou Wei, Wu Wang, Luying Huang
BACKGROUND: Toll-like receptor-2 (TLR2) and Toll-like receptor-4 (TLR4) have been reported to play a crucial role in tuberculosis, however, little is known about their expression in tuberculous pleuritis. OBJECTIVE: The goal of this work is to explore the expressions of TLR2 and TLR4 in tuberculous pleuritis and their predominant expressions on cells. METHODS: Levels of soluble TLR2 and TLR4 by enzyme linked immunosorbent assay (ELISA) in 58 patients with tuberculous pleural effusion (PE) and 43 patients with malignant PE were determined...
2017: Medicinal Chemistry
https://www.readbyqxmd.com/read/28410823/the-case-for-performing-pleural-biopsies-for-the-aetiological-diagnosis-of-exudates-yes
#12
F Rodriguez-Panadero
Pleural biopsies are especially indicated in the following circumstances: a) inconclusive pleural fluid analysis and negative sputum study, if adenosine deaminase (ADA) levels are unavailable; b) suspected multi-resistant tuberculosis; c) a need for differentiating tuberculous pleurisy (if it progresses with neutrophilia) and complicated parapneumonic effusion; d) malignant pleural effusion coexisting with very high ADA levels; e) effusion coexisting with lung cancer and negative pleural cytology; f) suspected mesothelioma; and g) need for implementing re-treatment for patients with relapse after chemotherapy...
October 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28119750/mycobacterium-tuberculosis-esat6-and-cpf10-induce-adenosine-deaminase-2-mrna-expression-in-monocyte-derived-macrophages
#13
Mi Jung Bae, Suyeon Ryu, Ha-Jeong Kim, Seung Ick Cha, Chang Ho Kim, Jaehee Lee
BACKGROUND: Delayed hypersensitivity plays a large role in the pathogenesis of tuberculous pleural effusion (TPE). Macrophages infected with live Mycobacterium tuberculosis (MTB) increase the levels of adenosine deaminase2 (ADA2) in the pleural fluid of TPE patients. However, it is as yet unclear whether ADA2 can be produced by macrophages when challenged with MTB antigens alone. This study therefore evaluated the levels of ADA2 mRNA expression, using monocyte-derived macrophages (MDMs) stimulated with MTB antigens...
January 2017: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28057604/biological-markers-in-the-diagnosis-of-tuberculous-pleural-effusion
#14
REVIEW
Bastien Mollo, Stéphane Jouveshomme, François Philippart, Benoît Pilmis
Tuberculosis is one of the main etiologies to evoke in the context of lymphocyte pleurisy. However, diagnosis is difficult and is based on mycobacteriology that is not enough sensitive and time-consuming, or on histology that requires invasive biopsy gesture. This literature review, carried out from Medline, summarizes the main meta-analyzes, reviews, and originator publications in English on biomarkers, classic and more innovative, studied for the diagnosis of tuberculous pleurisy. Among the immuno-biochemical markers, interferon-γ (IFN-γ), isoenzyme of adenosine deaminase 2 (ADA2) and total adenosine deaminase (ADA) seem the most relevant with respective sensitivities of 89% (87-91), 97...
February 1, 2017: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/27725052/meta-analysis-of-indian-studies-evaluating-adenosine-deaminase-for-diagnosing-tuberculous-pleural-effusion
#15
A N Aggarwal, R Agarwal, I S Sehgal, S Dhooria, D Behera
OBJECTIVE: To determine the diagnostic accuracy of pleural fluid adenosine deaminase (ADA) in diagnosing tuberculous pleural effusion (TPE) among Indian patients using systematic review and meta-analysis. DESIGN: The PubMed, Embase, IndMED and Cochrane databases and other relevant publications were searched to identify Indian studies evaluating the sensitivity and specificity of ADA in diagnosing TPE. Pooled diagnostic accuracy measures and 95% confidence intervals (95%CI) were generated using a bivariate random-effects model, and examined using forest plots and hierarchical summary receiver operating characteristic (HSROC) curves...
October 2016: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/27677622/profile-of-metalloproteinases-and-their-association-with-inflammatory-markers-in-pleural-effusions
#16
Lisete Ribeiro Teixeira, Murilo B Dias, Roberta K B Sales, Leila Antonangelo, Vanessa A Alvarenga, Juliana Puka, Evaldo Marchi, Milena Marques Pagliarelli Acencio
BACKGROUND: Matrix metalloproteinases (MMPs) are responsible for the breakdown of the extracellular matrix and play an important role in the inflammatory processes of pleural exudates. The imbalance between MMPs and their inhibitors (TIMPs) is present in various pathological processes. OBJECTIVE: To evaluate the profile of MMPs and TIMPs in pleural effusions of different etiologies correlated with inflammatory markers. METHODS: The patients with pleural effusion due to tuberculosis (TB), cancer (CA) or transudate were prospectively evaluated...
December 2016: Lung
https://www.readbyqxmd.com/read/27570776/advances-in-the-diagnosis-of-tuberculous-pleuritis
#17
REVIEW
José M Porcel
Pleural tuberculosis (TB) remains difficult to diagnose. In about two-thirds of the cases the diagnosis is reliant upon clinical suspicion along with consistent fluid biochemistries (i.e., lymphocytic predominant exudates) and exclusion of other potential causes for the effusion. Microbiological methods for a confirmatory diagnosis of pleural TB, which include acid-fast smears (Ziehl-Nelseen), cultures on solid media (Lowenstein-Jensen) and polymerase chain reaction tests from either pleural fluid or sputum samples, remain suboptimal since they are positive in only a minority of patients...
August 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27499994/a-30-year-old-female-beh%C3%A3-et-s-disease-patient-with-recurrent-pleural-and-pericardial-effusion-and-elevated-adenosine-deaminase-levels-case-report
#18
Joon Young Choi, Sung-Hwan Kim, Seung-Ki Kwok, Jung Im Jung, Kyo-Young Lee, Tae-Jung Kim, Ji Young Kang
Behçet's disease is a systemic disease which may involve various organs. We describe a case of a patient diagnosed as pleuropericardial involvement of Behçet's disease. A 30-year-old woman visited our clinic presented with left pleuritic chest pain for s days. She had been diagnosed as Behçet's disease and admitted to our clinic due to pericardial and pleural effusion repeatedly in past two years. In the previous studies, effusion analysis revealed to be lympho-dominant exudate with high adenosine deaminase level...
July 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27488820/pleural-fluid-adenosine-deaminase-serum-c-reactive-protein-ratio-for-the-differentiation-of-tuberculous-and-parapneumonic-effusions-with-neutrophilic-predominance-and-high-adenosine-deaminase-levels
#19
Jaehee Lee, Seung Soo Yoo, Shin Yup Lee, Seung Ick Cha, Jae Yong Park, Chang Ho Kim
PURPOSE: Tuberculous pleural effusion (TPE) and parapneumonic effusion (PPE) are usually distinguished by cellular predominance and pleural fluid adenosine deaminase (ADA) levels. However, both diseases may occasionally show similar neutrophilic predominance and high ADA levels. In such cases, the differential diagnosis between TPE and PPE is challenging and has been rarely investigated. METHODS: A retrospective study was conducted on TPE and PPE patients with neutrophilic exudate and pleural fluid ADA levels ≥40 U/L...
February 2017: Infection
https://www.readbyqxmd.com/read/27485497/a-combination-of-the-quantiferon-tb-gold-in-tube-assay-and-the-detection-of-adenosine-deaminase-improves-the-diagnosis-of-tuberculous-pleural-effusion
#20
Yuanyuan Liu, Qinfang Ou, Jian Zheng, Lei Shen, Bingyan Zhang, Xinhua Weng, Lingyun Shao, Yan Gao, Wenhong Zhang
The differential diagnosis of tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE) remains difficult despite the availability of numerous diagnostic tools. The current study aimed to evaluate the performance of the whole blood QuantiFERON-TB Gold In-Tube (QFT-GIT) assay and conventional laboratory biomarkers in differential diagnosis of TPE and MPE in high tuberculosis prevalence areas. A total of 117 patients with pleural effusions were recruited, including 91 with TPE and 26 with MPE. All of the patients were tested with QFT-GIT, and the conventional biomarkers in both blood and pleural effusion were detected...
August 3, 2016: Emerging Microbes & Infections
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