n Cardiovascular Journal of South Africa - Adenosine deaminase activity - more than a diagnostic tool in tuberculous pericarditis : cardiovascular topic

Volume 16, Issue 3
  • ISSN : 1680-0745



&lt;I&gt;Aim:&lt;/I&gt; To improve the understanding of factors that influence adenosine deaminase (ADA) activity in large pericardial effusions. &lt;br&gt;&lt;I&gt;Methods:&lt;/I&gt; A prospective study was carried out at Tygerberg Academic Hospital, South Africa. Patients underwent echocardiographically guided pericardiocentesis. ADA activity, as well as biochemistry, haematology, cytology, and in some cases, histology, were determined. Human immunodeficiency virus (HIV) status was assessed in all patients. &lt;br&gt;&lt;I&gt;Results:&lt;/I&gt; Two hundred and thirty-three patients presented to Tygerberg Hospital with large pericardial effusions requiring pericardiocentesis. Tuberculous pericarditis accounted for 162 effusions (69.5%). An ADA cut-off level of 40 U/l resulted in a test sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic efficiency of 84.0%, 80.0%, 91.0%, 66.0% and 83.0%, respectively. Pericardial exudates with an ADA activity &lt;u&gt;&gt;&lt;/u&gt; 40 U/l were associated with increased total leukocyte and neutro - phil counts. Patients with tuberculous pericarditis and ADA &lt;u&gt;&gt;&lt;/u&gt; 40 U/l also had increased lymphocyte counts. Pericardial ADA activity < 30 U/l was associated with severe depletion of CD4 cell counts in HIV-positive patients. ADA levels were higher in cases with histological evidence of granulomatous inflammation than in cases with serofibrinous pericarditis. &lt;br&gt;&lt;I&gt;Conclusions:&lt;/I&gt; An ADA cut-off level of 40 U/l results in best diagnostic test results. ADA production appears to be influenced by factors associated with the antituberculous immune response.

Loading full text...

Full text loading...


Article metrics loading...


This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error