Adenosine deaminase activity in diagnosis of tuberculous ascites

Abstract

Between April 1993-September 1995, we studied the activity of adenosine deaminase (ADA) in the peritoneal fluid of 72 patients who were divided into three groups according to causes of ascites, as follows: tuberculous peritonitis (group I), secondary to malignant tumors (group II), cirrhosis of the liver (group III). In tuberculous ascitic fluid, ADA levels were 55.4±7.3 IU/L (mean±SD), which was significantly more than that noted in cirrhotic (7.6±3.9 IU/L), or malignant (15.5±7.7 IU/L) ascitic fluids (P<0.001, for each). At a cutt-off value of greater than 30IU/L, the sensitivity, specificity, positive and negative predictive values were 95.7%, 100%, 92.5% and 100%, respectively. These findings suggest that the ascitic fluid ADA activity may be used to identify patients in whom the diagnosis of abdominal tuberculosis must be pursued.