[ Rôle de l’adénosine désaminase dans le diagnostic de la tuberculose pleurale ]
Hanane Charaf1, Bouchra Daher2, Mouna Soualhi3, Rachida Zahraoui4, and Jamal Eddine Bourkadi5
1 Service de Pneumo-Phtisiologie, l’Hôpital Moulay Youssef, Institut Mohammed V, Rabat, Morocco
2 Service de Pneumo-Phtisiologie, l’Hôpital Moulay Youssef, Institut Mohammed V, Rabat, Morocco
3 Service de Pneumo-Phtisiologie, l’Hôpital Moulay Youssef, Institut Mohammed V, Rabat, Morocco
4 Service de Pneumo-Phtisiologie, l’Hôpital Moulay Youssef, Institut Mohammed V, Rabat, Morocco
5 Service de Pneumo-Phtisiologie, l’Hôpital Moulay Youssef, Institut Mohammed V, Rabat, Morocco
Original language: French
Copyright © 2024 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Tuberculosis (TB) is a bacterial infection that can affect many organs including the pleura, and its diagnosis is not always easy. Adenosine deaminase (ADA) has been developed and widely used for the diagnosis of tuberculosis. Objective: To determine the diagnostic utility of adenosine deaminase (ADA) in a series of 80 pleural effusions, and whether pleural ADA can replace pleural biopsy in the evaluation of suspected pleural tuberculosis. We also propose a review of the literature on the characteristics, metabolism and clinical uses of ADA for the diagnosis of pleural tuberculosis in clinical practice. Methods: This is a retrospective study of 200 patients with pleural effusion, of whom 80 patients had an adenosine deaminase assay in pleural fluid. The study was conducted at the day hospital of Moulay Youssef Hospital, CHU Ibn Sina of Rabat, during the year of 2018. Results: Among 200 patients admitted for pleurisy exploration, 80 patients had benefited from adenosine deaminase assay, 90% of pleurisies were of tubercular origin, 75% were retained on histological arguments (by pleural biopsy), while the remainder were retained in front of clinical, biological, radiological and evolutionary arguments. The median pleural ADA level was 53 IU/L. Conclusion: ADA is a rapid and precise means of detecting tuberculous pleurisy, it can be used to support the diagnosis and in particular in case of absence of histological evidence either in front of the impossibility of realization of a pleural biopsy (child, effusion of small abundance), or in front of a not contributive anatomo-pathological result.
Author Keywords: ADA, Adenosine deaminase, pleural tuberculosis.
Hanane Charaf1, Bouchra Daher2, Mouna Soualhi3, Rachida Zahraoui4, and Jamal Eddine Bourkadi5
1 Service de Pneumo-Phtisiologie, l’Hôpital Moulay Youssef, Institut Mohammed V, Rabat, Morocco
2 Service de Pneumo-Phtisiologie, l’Hôpital Moulay Youssef, Institut Mohammed V, Rabat, Morocco
3 Service de Pneumo-Phtisiologie, l’Hôpital Moulay Youssef, Institut Mohammed V, Rabat, Morocco
4 Service de Pneumo-Phtisiologie, l’Hôpital Moulay Youssef, Institut Mohammed V, Rabat, Morocco
5 Service de Pneumo-Phtisiologie, l’Hôpital Moulay Youssef, Institut Mohammed V, Rabat, Morocco
Original language: French
Copyright © 2024 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Tuberculosis (TB) is a bacterial infection that can affect many organs including the pleura, and its diagnosis is not always easy. Adenosine deaminase (ADA) has been developed and widely used for the diagnosis of tuberculosis. Objective: To determine the diagnostic utility of adenosine deaminase (ADA) in a series of 80 pleural effusions, and whether pleural ADA can replace pleural biopsy in the evaluation of suspected pleural tuberculosis. We also propose a review of the literature on the characteristics, metabolism and clinical uses of ADA for the diagnosis of pleural tuberculosis in clinical practice. Methods: This is a retrospective study of 200 patients with pleural effusion, of whom 80 patients had an adenosine deaminase assay in pleural fluid. The study was conducted at the day hospital of Moulay Youssef Hospital, CHU Ibn Sina of Rabat, during the year of 2018. Results: Among 200 patients admitted for pleurisy exploration, 80 patients had benefited from adenosine deaminase assay, 90% of pleurisies were of tubercular origin, 75% were retained on histological arguments (by pleural biopsy), while the remainder were retained in front of clinical, biological, radiological and evolutionary arguments. The median pleural ADA level was 53 IU/L. Conclusion: ADA is a rapid and precise means of detecting tuberculous pleurisy, it can be used to support the diagnosis and in particular in case of absence of histological evidence either in front of the impossibility of realization of a pleural biopsy (child, effusion of small abundance), or in front of a not contributive anatomo-pathological result.
Author Keywords: ADA, Adenosine deaminase, pleural tuberculosis.
Abstract: (french)
Contexte: La tuberculose est une infection bactérienne pouvant toucher de nombreux organes y compris la plèvre, le diagnostic de cette dernière n’est pas toujours aisé. L’adénosine désaminase (ADA) a été développée et largement utilisée pour le diagnostic de la tuberculose. L’objectif: Déterminer l’utilité diagnostique de l’adénosine désaminase (ADA) dans une série de 80 d’épanchements pleuraux, et de savoir si l’ADA pleurale peut remplacer la biopsie pleurale pour l’évaluation d’une suspicion de tuberculose pleurale. Nous proposant également une revue de littérature sur les caractéristiques, le métabolisme et les utilisations cliniques de l’ADA pour le diagnostic de la tuberculose pleurale dans la pratique clinique. Méthodes: Il s’agit d’une étude rétrospective de 200 patients présentant un épanchement pleural, dont 80 patients ayant réalisé un dosage de l’adénosine désaminase dans le liquide pleural. L’étude a été réalisée à l’hôpital du jour de l’hôpital Moulay Youssef, CHU Ibn Sina du Rabat. Résultats: Parmi les 200 patients admis pour exploration d’une pleurésie, 80 malades avaient bénéficié du dosage de l’adénosine désaminase, 90% des pleurésies étaient d’origine tuberculeuse, 75 % étaient retenues sur des arguments histologiques (par biopsie pleurale), alors que le reste était retenu devant des arguments cliniques, biologiques, radiologiques et évolutives. Le taux médian d’ADA pleural était de 53UI/L. Conclusion: ADA est un moyen rapide et précis de détecter la pleurésie tuberculeuse, elle peut être utilisée pour appuyer le diagnostic et en particulier en cas d’absence d’une preuve histologique soit devant l’impossibilité de réalisation d’une biopsie pleurale (l’enfant, épanchement de faible abondance), ou devant un résultat anatomo-pathologique non contributif.
Author Keywords: ADA, Adénosine désaminase, tuberculose pleurale.
