Saeed M Alinejad, Genadi L Gurevich, Anatoli D Tahanovich.
Biochemical markers in patients with tuberculous pleural effusion.
Pak J Med Res Jan ;48(3):55-9.

Objectives: To compare the diagnostic efficiency of adenosine deaminase, isoenzyme adenosine deaminase-2 and concentration of interferon-γ in patients with tuberculous pleural effusion. Materials and Methods: The prospective study was done on 103 patients who were divided into 3 groups: tuberculous, non-tuberculous infectious pleurisy, and malignant effusion. The adenosine deaminase, adenosine deaminase-2 and interferon-γ were analyzed by receiver operating characteristic curves. Results: There was increase of all three markers in tuberculous pleural effusion but not in nontuberculous effusion. The cut-off values for adenosine deaminase, adenosine deaminase-2 and interferon-γ were 40, 26 U/l. and 299 pg/ml respectively. Adenosine deaminase, adenosine deaminase-2 activities were significantly higher in tuberculous effusion than in malignant pleural effusion (more than 5 times) and in non-tuberculous infectious pleurisy (more than 4 times). The median of interferon-γ concentration in pleural fluid of tuberculous patients was 1514.2 pg/ml (931.2-2187.5pg/ml) which was 10 times more than the median values of other groups of patients. There was no significant difference between patients with malignant effusion and those with non-tuberculous effusion. Conclusions: All three markers had higher diagnostic yield for tuberculous effusion.

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