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Garg, I., Arora, D., Joshi, H., Kumar, A., & Awasthi, S. (2021). Association of Serum Adenosine Deaminase Levels in Cytologically Suggested Cases of Tubercular Lymphadenitis: The Experience of a Tertiary Care Centre. Sudan Journal of Medical Sciences (SJMS), 16(3), 386–398. https://doi.org/10.18502/sjms.v16i3.9699

https://doi.org/10.18502/sjms.v16i3.9699

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authors

  • Ina Garg

    Ina Garg

    Department of Pathology, Teerthanker Mahaveer Medical College & Research Centre (TMMC&RC), Moradabad, Uttar Pradesh, India
  • Deepti Arora

    Deepti Arora

    Department of Pathology, Teerthanker Mahaveer Medical College & Research Centre (TMMC&RC), Moradabad, Uttar Pradesh, India
  • Himanshu Joshi

    Himanshu Joshi

    Department of Pathology, Teerthanker Mahaveer Medical College & Research Centre (TMMC&RC), Moradabad, Uttar Pradesh, India
  • Ashutosh Kumar

    Ashutosh Kumar

    Department of Pathology, Teerthanker Mahaveer Medical College & Research Centre (TMMC&RC), Moradabad, Uttar Pradesh, India
  • Seema Awasthi

    Seema Awasthi

    Department of Pathology, Teerthanker Mahaveer Medical College & Research Centre (TMMC&RC), Moradabad, Uttar Pradesh, India

Published Date

  • Sep 30, 2021

Association of Serum Adenosine Deaminase Levels in Cytologically Suggested Cases of Tubercular Lymphadenitis: The Experience of a Tertiary Care Centre

Sudan Journal of Medical Sciences (SJMS) / Sudan JMS: Volume 16 (2021), Issue No. 3 / Pages 386–398

Abstract

Background: Tuberculosis (TB), a communicable disease, caused by Mycobacterium tuberculosis requires a simple, rapid test, which can be easily carried out in a laboratory. Unfortunately, despite a battery of investigations, no definite test is available till date. Adenosine deaminase (ADA), a biochemical marker has been proposed as a useful surrogate marker for TB as its levels can be measured in body fluids.


Methods: A one-and-a-half-year prospective study of 154 cases presenting with lymphadenitis from January 2019 to June 2020 was undertaken. Using cytology, lymphadenitis subjects were divided into two groups: Tubercular (104 patients) as a case group and Reactive (50 patients) as a control group. All cases were followed by serum ADA assay by colorimetric method. Nonparametric tests were performed to compare the two groups.


Results: The mean age of the participants was 28.99 ± 13.26 years with a F:M ratio of 1.81:1. Involvement of cervical lymph nodes was most frequent (89.42% cases). The mean S.ADA level for tubercular and reactive lymphadenitis was 41.71 ± 11.53 U/L and 21.16 ± 4.16 U/L, respectively (P-value < 0.05). The cut-off value calculated was 32.6 U/L. The sensitivity, specificity, PPV, NPV, and accuracy were calculated as 79.81%, 100%, 100%, 70.42%, and 86.36%, respectively.


Conclusion: A statistically significant increase was found in serum ADA levels in tubercular lymphadenitis cases compared to reactive lymphadenitis. Hence, it can be used as an adjunct to FNAC and is a fairly sensitive and specific test. Since it is difficult to always demonstrate AFB in FNAC smears, ADA can be helpful in establishing a definite diagnosis despite smear negativity.


Keywords: adenosine deaminase, lymphadenitis, tuberculosis

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