Analysis of broncho alveolar lavage adenosine deaminase assay in patients with clinically diagnosed pulmonary tuberculosis

Background: The sputum smear-negative pulmonary tuberculosis (PTB) is a diagnostic challenge for physicians. It has been shown that adenosine deaminase (ADA) activity increases in various body fluids of patients with tuberculosis (TB). A prospective clinical trial was conducted to determine the effe...

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Main Authors: Deep Rajendrabhai Kothari, Nilesh Dutt, Palak Prajapati, Pankaj Garg, Mamta Patel
Format: Article
Language:English
Published: Golestan University of Medical Sciences 2024-05-01
Series:Medical Laboratory Journal
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Online Access:http://mlj.goums.ac.ir/article-1-1612-en.pdf
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author Deep Rajendrabhai Kothari
Nilesh Dutt
Palak Prajapati
Pankaj Garg
Mamta Patel
author_facet Deep Rajendrabhai Kothari
Nilesh Dutt
Palak Prajapati
Pankaj Garg
Mamta Patel
author_sort Deep Rajendrabhai Kothari
collection DOAJ
description Background: The sputum smear-negative pulmonary tuberculosis (PTB) is a diagnostic challenge for physicians. It has been shown that adenosine deaminase (ADA) activity increases in various body fluids of patients with tuberculosis (TB). A prospective clinical trial was conducted to determine the effectiveness of ADA activity in bronchoalveolar lavage (BAL) in subjects who have sputum smear-negative PTB. Methods: A total of 29 patients (M/F: 15/14), mean age (36.8 years), were enrolled in our study from October 2021 to August 2022 after providing written consent. The mean duration of symptoms was 41.66 days. Out of 29 patients, 21 patients had BAL ADA 4.81±1.68 unit??, for whom AKT treatment was started and cured, while four patients with BAL ADA 4.50±2.86 unit? did not improve, and four patients with BAL ADA 6.52±1.16 whose AKT treatment is ongoing at present but clinically improved. The sensitivity of BAL ADA with the outcome of 29 patients is 75%, while for BAL CBNAAT, it is 80%. When we apply a formula for combined sensitivity for the parallel test, then it comes to 95%, which indicates a great number of patients gets the benefit when we apply both tests simultaneously. Results: We conclude that ADA activity was significantly increased in BAL. Conclusion: BAL ADA is a useful and effective investigation for the diagnosis of PTB.
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institution Kabale University
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publishDate 2024-05-01
publisher Golestan University of Medical Sciences
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spelling doaj-art-99d2fa89f44542f1957e9b0ee3fe5fd82024-11-18T05:19:42ZengGolestan University of Medical SciencesMedical Laboratory Journal2538-44492024-05-0118313Analysis of broncho alveolar lavage adenosine deaminase assay in patients with clinically diagnosed pulmonary tuberculosisDeep Rajendrabhai Kothari0Nilesh Dutt1Palak Prajapati2Pankaj Garg3Mamta Patel4 Department of Respiratory Medicine, Narendra Modi Medical College, Maninagar, Ahmedabad, India Department of Respiratory Medicine, Narendra Modi Medical College, Maninagar, Ahmedabad, India Department of Respiratory Medicine, Narendra Modi Medical College, Maninagar, Ahmedabad, India NHL Municipal Medical College, Paldi, Ahmedabad, India Department of Respiratory Medicine, Narendra Modi Medical College, Maninagar, Ahmedabad, India Background: The sputum smear-negative pulmonary tuberculosis (PTB) is a diagnostic challenge for physicians. It has been shown that adenosine deaminase (ADA) activity increases in various body fluids of patients with tuberculosis (TB). A prospective clinical trial was conducted to determine the effectiveness of ADA activity in bronchoalveolar lavage (BAL) in subjects who have sputum smear-negative PTB. Methods: A total of 29 patients (M/F: 15/14), mean age (36.8 years), were enrolled in our study from October 2021 to August 2022 after providing written consent. The mean duration of symptoms was 41.66 days. Out of 29 patients, 21 patients had BAL ADA 4.81±1.68 unit??, for whom AKT treatment was started and cured, while four patients with BAL ADA 4.50±2.86 unit? did not improve, and four patients with BAL ADA 6.52±1.16 whose AKT treatment is ongoing at present but clinically improved. The sensitivity of BAL ADA with the outcome of 29 patients is 75%, while for BAL CBNAAT, it is 80%. When we apply a formula for combined sensitivity for the parallel test, then it comes to 95%, which indicates a great number of patients gets the benefit when we apply both tests simultaneously. Results: We conclude that ADA activity was significantly increased in BAL. Conclusion: BAL ADA is a useful and effective investigation for the diagnosis of PTB.http://mlj.goums.ac.ir/article-1-1612-en.pdfpulmonary tuberculosisadenosine deaminasebronchoalveolar lavage
spellingShingle Deep Rajendrabhai Kothari
Nilesh Dutt
Palak Prajapati
Pankaj Garg
Mamta Patel
Analysis of broncho alveolar lavage adenosine deaminase assay in patients with clinically diagnosed pulmonary tuberculosis
Medical Laboratory Journal
pulmonary tuberculosis
adenosine deaminase
bronchoalveolar lavage
title Analysis of broncho alveolar lavage adenosine deaminase assay in patients with clinically diagnosed pulmonary tuberculosis
title_full Analysis of broncho alveolar lavage adenosine deaminase assay in patients with clinically diagnosed pulmonary tuberculosis
title_fullStr Analysis of broncho alveolar lavage adenosine deaminase assay in patients with clinically diagnosed pulmonary tuberculosis
title_full_unstemmed Analysis of broncho alveolar lavage adenosine deaminase assay in patients with clinically diagnosed pulmonary tuberculosis
title_short Analysis of broncho alveolar lavage adenosine deaminase assay in patients with clinically diagnosed pulmonary tuberculosis
title_sort analysis of broncho alveolar lavage adenosine deaminase assay in patients with clinically diagnosed pulmonary tuberculosis
topic pulmonary tuberculosis
adenosine deaminase
bronchoalveolar lavage
url http://mlj.goums.ac.ir/article-1-1612-en.pdf
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