J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 2, Number 3, June 2010, pages 121-126

Sensitivity, Specificity, Negative and Positive Predictive Values of Adenosine Deaminase in Patients of Tubercular and Non-Tubercular Serosal Effusion in India

**Table 1.** Reference Values of ADA in Various Body Fluids (U/L)
Type of Fluid	Negative	Positive
Serum/plasma/Pleural/Ascitic/synovial Fluids	40 or < 40	> 40
CSF	10 or < 10	> 10

Table 1. Reference Values of ADA in Various Body Fluids (U/L)

Type of Fluid

Negative

Positive

Serum/plasma/Pleural/Ascitic/synovial Fluids

40 or < 40

> 40

CSF

10 or < 10

> 10

**Table 2.** Table Showing Distribution of Cases According to the Initial Set Criteria
Type of Disease	Aspirated Fluid	Etiology; According to Set Criteria	Number of Cases
1. Pulmonary	Pleural (n = 72)	Tuberculous	42
Non tuberculous	30
2. Extra-Pulmonary	Ascitic / Peritoneal (n = 108)	Tuberculous	36
Non tuberculous	72
CSF (n = 120)	Tuberculous	54
Non tuberculous	66
Synovial (n = 30)	Tuberculous	21
Non tuberculous	09
Total	330

Table 2. Table Showing Distribution of Cases According to the Initial Set Criteria

Type of Disease

Aspirated Fluid

Etiology;
According to Set Criteria

Number of Cases

1. Pulmonary

Pleural (n = 72)

Tuberculous

Non tuberculous

2. Extra-Pulmonary

Ascitic / Peritoneal (n = 108)

Tuberculous

Non tuberculous

CSF (n = 120)

Tuberculous

Non tuberculous

Synovial (n = 30)

Tuberculous

Non tuberculous

Total

330

**Table 3.** Table Showing ADA and AFB Positivity in Tubercular Group
Type of Tubercular Disease	Aspirated Fluid	Etiology; No. of Tubercular Cases According to Set Criteria	AFB Positive Cases
Pulmonary (n = 42)	Pleural (n = 72)	42	14
Extra-Pulmonary (n = 111)	Ascitic/Peritoneal (n = 108)	36	09
CSF (n = 120)	54	nil
Synovial (n = 30)	21	nil
Total	153	23

Table 3. Table Showing ADA and AFB Positivity in Tubercular Group

Type of Tubercular Disease

Aspirated Fluid

Etiology; No. of Tubercular Cases According to Set Criteria

AFB Positive Cases

Pulmonary (n = 42)

Pleural (n = 72)

Extra-Pulmonary (n = 111)

Ascitic/Peritoneal (n = 108)

CSF (n = 120)

nil

Synovial (n = 30)

nil

Total

153

**Table 4.** Table Showing Range of ADA With Median Corresponding to Etiology
Type of Fluid	Cut Off	Range U/L	Median
Pleural	> 40	40.4 - 136	88
≤ 40	4.8 - 38	21.5
Ascitic/Peritoneal	> 40	48 - 180	110
≤ 40	3.3 - 40	16
Synovial	> 40	46 - 156	88
≤ 40	25 - 32.6	27.2
CSF	> 10	10.2 - 110	24
≤ 10	2 - 10	6.4

Table 4. Table Showing Range of ADA With Median Corresponding to Etiology

Type of Fluid

Cut Off

Range U/L

Median

Pleural

> 40

40.4 - 136

≤ 40

4.8 - 38

21.5

Ascitic/Peritoneal

> 40

48 - 180

110

≤ 40

3.3 - 40

Synovial

> 40

46 - 156

≤ 40

25 - 32.6

27.2

CSF

> 10

10.2 - 110

≤ 10

2 - 10

6.4

**Table 5.** Sensitivity, Specificity, Negative and Positive Predictive Values of ADA Estimation in Different Groups
Type of Disease	Aspirated Fluid	Etiology According to Set Criteria	Cut Off Value of ADA	Number of True Positive/Negative Cases	Sensitivity %	Specificity %	Positive Predictive Value %	Negative Predictive Value %
Pulmonary (n = 72)	Pleural (n = 72)	Tuberculous (n = 42)	> 40	39	92.80	90.00	92.86	90.00
Non-tuberculous (n = 30)	≤ 40	27
Extra-Pulmonary (n = 258)	Over all includes;	Tuberculous (n = 111)	> 40 / 10	99	94.29	92.16	89.00	95.92
Non-tuberculous (n = 147)	≤ 40 / 10	141
Ascitic (n = 108)	Tuberculous (n = 36)	> 40	33	100	96	91.67	100.00
Non-tuberculous (n = 72)	≤ 40	72
Synovial (n = 30)	Tuberculous (n = 21)	> 40	18	85.71	66.67	85.71	66.67
Non-tuberculous (n = 09)	≤ 40	06
CSF (n = 120)	Tuberculous (n = 54)	> 10	48	84.12	91.30	88.89	95.46
Non-tuberculous (n = 66)	≤ 10	63

Table 5. Sensitivity, Specificity, Negative and Positive Predictive Values of ADA Estimation in Different Groups

Type of Disease

Aspirated Fluid

Etiology According to Set Criteria

Cut Off Value of ADA

Number of True Positive/Negative Cases

Sensitivity %

Specificity %

Positive Predictive Value %

Negative Predictive Value %

Pulmonary (n = 72)

Pleural (n = 72)

Tuberculous (n = 42)

> 40

92.80

90.00

92.86

90.00

Non-tuberculous (n = 30)

≤ 40

Extra-Pulmonary (n = 258)

Over all includes;

Tuberculous (n = 111)

> 40 / 10

94.29

92.16

89.00

95.92

Non-tuberculous (n = 147)

≤ 40 / 10

141

Ascitic (n = 108)

Tuberculous (n = 36)

> 40

100

91.67

100.00

Non-tuberculous (n = 72)

≤ 40

Synovial (n = 30)

Tuberculous (n = 21)

> 40

85.71

66.67

85.71

66.67

Non-tuberculous (n = 09)

≤ 40

CSF (n = 120)

Tuberculous (n = 54)

> 10

84.12

91.30

88.89

95.46

Non-tuberculous (n = 66)

≤ 10