HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Value of adenosine deaminase (ADA) in ascitic fluid for the diagnosis of tuberculous peritonitis: a meta-analysis.

AbstractBACKGROUND AND GOALS:
Adenosine deaminase (ADA) levels are used for diagnosing tuberculosis in several locations and although many studies have evaluated ADA levels in ascitic fluid. These studies have defined arbitrary cut-off points creating difficulties in the clinical application of the results. The goals of this study are: to determine the usefulness of ADA levels in ascitic fluid as a diagnostic test for peritoneal tuberculosis (PTB) and define the best cut-off point.
STUDY:
A systematic review was done on the basis of 2 independent searches. We selected prospective studies that included consecutive patients. Diagnosis of PTB had to be confirmed by bacteriologic or histologic methods and ADA levels determined by the Giusti method. Inclusion/exclusion criteria were applied by 2 independent reviewers. A receiver operating characteristic curve was constructed to establish the optimal cut-off point and the likelihood ratios (LRs) estimated using fixed-effect pooled method.
RESULTS:
Twelve prospective studies were found. Four of them met the inclusion criteria and were thus included in the meta-analysis. They included 264 patients, of which 50 (18.9%) had PTB. ADA levels showed high sensitivity (100%) and specificity (97%) using cut-off values from 36 to 40 IU/L. The included studies were homogeneous. Optimal cut-off point was determined at 39 IU/L, and LRs were 26.8 and 0.038 for values above and below this cut-off.
CONCLUSIONS:
This study supports the proposition that ADA determination is a fast and discriminating test for diagnosing PTB with an optimal cut-off value of 39 IU/L.
AuthorsArnoldo Riquelme, Mario Calvo, Felipe Salech, Sebastián Valderrama, Alejandro Pattillo, Marco Arellano, Marco Arrese, Alejandro Soza, Paola Viviani, Luz María Letelier
JournalJournal of clinical gastroenterology (J Clin Gastroenterol) Vol. 40 Issue 8 Pg. 705-10 (Sep 2006) ISSN: 0192-0790 [Print] United States
PMID16940883 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
Chemical References
  • Adenosine Deaminase
Topics
  • Adenosine Deaminase (metabolism)
  • Ascitic Fluid (enzymology)
  • Clinical Enzyme Tests
  • Humans
  • Peritonitis, Tuberculous (diagnosis)
  • Prospective Studies
  • ROC Curve
  • Sensitivity and Specificity

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: