April - June 2019

Clinical utility of ADA / Gene Xpert for the Diagnosis of Tubercular Pleural Effusion in a Tertiary Care Centre

Vinitha Jose, PT Rothman, Sanjeev Narang , Maj Gen SK Nema

1 Department of Pathology Index Medical College Hospital and Research Centre, Indore
2 Department of Pulmonary Medicine Index Medical College Hospital and Research Centre, Indore


BACKGROUND AND OBJECTIVES: Tuberculosis is one of the oldest and most prevalent diseases in our country . The greatest burden of Tuberculosis incidence & mortality in India is in adults which include the most productive members of the society. Advances in Sputum microscopy and radiological methods improved the diagnostic yield in pulmonary tuberculosis, but the diagnosis of Extrapulmonary tuberculosis still remains a difficult job due to the paucibacillary nature of the disease. The main objective of our study was to evaluate the combined utility of Genexpert/PCR with ADA levels in diagnosis of EPTB in Pleural Effusions. METHODS: Our study was a cross sectional comparative study. A total of 44 cases who met the inclusion and exclusion criteria were included in the study, after taking ethical committee approval and proper consent from patients.. Every diagnosis was recorded, tabulated and compiled to yield the Sensitivity, Specificity, Positive Predictive Value and Negative Predictive Value. RESULTS: The statistical analysis showed that ADA compared to Genexpert had a sensitivity of 94.11% , specificity of 3.70%, Positive predictive value of 38.09% and a Negative predictive value of 50%. in Pleural Fluid and Gene expert showed a sensitivity of 38.10% , specificity of 50%, Positive predictive value of 94.12% and a Negative predictive value of 3.70%. CONCLUSION: The authors concluded that collective use of ADA and Genexpert can significantly improve the diagnostic yield of Tubercular Pleural Effusions.

Keywords: Tuberculosis, Pleural effusion, ADA, Genexpert

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