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ADA pleural effusion

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...
April 12, 2017: Revista Clínica Española
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
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
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
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...
September 27, 2016: Lung
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
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
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
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
Luis Corral-Gudino, Alberto García-Zamalloa, Cristina Prada-González, Silvia Bielsa, Duckens Alexis, Jorge Taboada-Gómez, Pilar R Dos-Santos-Gallego, María A Alonso-Fernández, Jose M Porcel
BACKGROUND: The frequency of "complicated" pleural effusions (CPE) (i.e., pleural fluid pH ≤ 7.2 and/or glucose ≤60 mg/dL) of tuberculous origin (CTPE) is not well reported. This study aims to quantify their prevalence, and develop a score to differentiate CTPE from complicated parapneumonic effusions (CPPE). METHODS: Retrospective analysis of databases from three Spanish hospitals which included patients with CTPE and CPPE. Forty percent of the study population served to generate a scoring system (COMPLES, COMplicated PLeural Effusion Score) that was further validated in the remaining 60 %...
October 2016: Lung
Chang Ho Kim, So Yeon Lee, Yong Dae Lee, Seung Soo Yoo, Shin Yup Lee, Seung Ick Cha, Jae Yong Park, Jaehee Lee
Objective Although tuberculous pleural effusion (TPE) is commonly characterized by lymphocytic predominance and high adenosine deaminase (ADA) levels, it may present with neutrophilic predominance or low ADA levels, which are more commonly found in parapneumonic effusion (PPE) or malignant pleural effusion (MPE), respectively. A few studies have observed that the atypical pleural fluid profiles of these cases of TPE may resolve at follow-up thoracentesis. However, these observations were incompletely analyzed and lacked comparison with proper control groups...
2016: Internal Medicine
Ricardo Mingarini Terra, Leila Antonangelo, Alessandro Wasum Mariani, Ricardo Lopes Moraes de Oliveira, Lisete Ribeiro Teixeira, Paulo Manuel Pego-Fernandes
PURPOSE: Systemic and local inflammations have been described as relevant prognostic factors in patients with cancer. However, parameters that stand for immune activity in the pleural space have not been tested as predictors of survival in patients with malignant pleural effusion. The objective of this study was to evaluate pleural lymphocytes and Adenosine Deaminase (ADA) as predictors of survival in patients with recurrent malignant pleural effusion. METHODS: Retrospective cohort study includes patients who underwent pleurodesis for malignant pleural effusion in a tertiary center...
August 2016: Lung
Tika Adilistya, Dalima Aw Astrawinata, Ujainah Z Nasir
AIM: to evaluate the diagnostic value of an interferon-gamma release assay (IGRA) with enzyme-linked immunospot (ELISPOT) method, T-SPOT.TB, in the diagnosis of pleural TB using pleural fluid mononuclear cells (PFMC). METHODS: forty-eight subjects, presumed to have pleural TB with exudative pleural effusion by Light's criteria, dominated by mononuclear cells, had their pleural fluid specimen tested with T-SPOT.TB, Mycobacterial Growth Indicator Tube (MGIT) culture, and adenosine deaminase (ADA) activity...
January 2016: Acta Medica Indonesiana
Min-Chul Kim, Sun-Mi Kim, Sang-Oh Lee, Sang-Ho Choi, Yang Soo Kim, Jun Hee Woo, Sung-Han Kim
BACKGROUND: Diagnosis of tuberculous (TB) pleurisy remains challenging due to the paucibacillary nature of the disease. We prospectively assessed the diagnostic usefulness of the T-cell based ELISPOT assay, and created a clinical algorithm for differentiating TB pleurisy from other diagnoses. METHODS: All adult patients with suspicion for TB pleurisy were enrolled in a tertiary hospital in Seoul, South Korea, over a 7-year period. ELISPOT assays were performed using mononuclear cells from peripheral blood and pleural effusion...
September 2016: Infectious Diseases
Alfredo S Golemba, Francisco G E Ferreyra, Gloria B Rovai, Fernando R Achinelli
Pleural tuberculosis ranks first in extrapulmonary sites. The aim of this study was to estimate the proportion pleural TB among TB cases, and characterize the presentation, diagnostic methods and outcomes of patients hospitalized in the ángela I. de Llano hospital, Corrientes, Argentina, between January 1, 2011 and June 30, 2014. We performed a descriptive and observational study. Ten patients were diagnosed with TB pleural effusion. The mean age was 48.5 ± 16.9 (16-63) years. The average evolution time before the consultation was 21...
2016: Medicina
Filiz Koşar, Sibel Yurt, Burcu Arpınar Yiğitbaş, Barış Şeker, Hatice Kutbay Özçelik, Hafize Uzun
INTRODUCTION: The aim of the present study was to evaluate and compare the diagnostic accuracy of pleura levels of adenosine deaminase (ADA) and neopterin for the differential diagnosis of pleural tuberculosis (TP). PATIENTS AND METHODS: The study included 50 patients with TB, 27 patients with malignancies, and 24 patients with pleural effusion of non-tuberculous and non-malignant origin as controls. ADA and neopterin levels in pleural fluid were measured by spectrofotometric and ELISA method, respectively...
2015: Tüberküloz Ve Toraks
Jean-Marie Michot, Yoann Madec, Sophie Bulifon, Cécile Thorette-Tcherniak, Nicolas Fortineau, Nicolas Noël, Olivier Lambotte, Younes El Jahiri, Hervé Delacour, Jean-François Delfraissy, François-Xavier Blanc
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...
March 2016: Diagnostic Microbiology and Infectious Disease
Akash Verma, John Abisheganaden, R W Light
AIM: We studied the diagnostic potential of serum lactate dehydrogenase (LDH) in malignant pleural effusion. METHODS: Retrospective analysis of patients hospitalized with exudative pleural effusion in 2013. RESULTS: Serum LDH and serum LDH: pleural fluid ADA ratio was significantly higher in cancer patients presenting with exudative pleural effusion. In multivariate logistic regression analysis, pleural fluid ADA was negatively correlated 0...
February 2016: Lung
J-L Wang, G-W Zhao, Z-Q Zhang, X-F Wang, M-S Wang
OBJECTIVE: The aim of this study was to describe the clinicopathologic characteristics of pediatric tuberculous pleural effusion (TPE) patients to make an accurate diagnosis. PATIENTS AND METHODS: Pediatric TPE patients who admitted to Shandong Provincial Chest Hospital were retrospectively reviewed from March 2006 to April 2015. RESULTS: 112 pediatric TPE patients were enrolled. The mean age was 11.6 ± 3.2 years. 60 (53.6%) patients were diagnosed as TPE, 40 (35...
August 2015: European Review for Medical and Pharmacological Sciences
A Farhana, C K Ghosh, Z Rehena, S Ferdousi, M B Alam, M Mahmuduzzaman, A I Joarder, Q Rahman, A N Ahmed
Though pulmonary tuberculosis is the common presentation of Mycobacterium tuberculosis infection, extra-pulmonary tuberculosis is also a growing problem worldwide. Tuberculous pleural effusion is the second frequent form of extra-pulmonary presentation after tuberculous lymphadenitis and if untreated up to 65% of patients with tubercular pleural effusions will eventually develop active TB. Traditional diagnostic methods are very useful for the diagnosis of pulmonary TB but have a low yield when applied to pleural fluid...
July 2015: Mymensingh Medical Journal: MMJ
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