CLINICAL STUDY OF PAEDIATRIC TUBERCULOSIS WITH REFERENCE TO ADENOSINE DEAMINASE LEVEL IN COMPARISON WITH DNA PCR FOR DIAGNOSIS OF MYCOBACTERIUM TUBERCULOSIS

BACKGROUND
\nTo study the clinical profile of paediatric tuberculosis with reference to adenosine deaminase level in comparison with DNA PCR
\nfor diagnosis of mycobacterium tuberculosis. Tuberculosis is still a leading cause of death worldwide. After a century of
\nstagnation, new technologies for the diagnosis of tuberculosis, new molecular based technologies were approved for the
\ndetection of Mycobacterium tuberculosis.
\nMATERIALS AND METHODS
\nIn the study, 50 patients of tuberculosis were studied in detail regarding presentation of various forms of tuberculosis (TB
\nmeningitis, pulmonary tuberculosis) with respect to age of presentation, BCG vaccination status, and sex distribution, history of
\ncontact, MT positivity, and clinical features. Investigations done were Complete Blood Count with peripheral smear, ESR, chest
\nx-ray, acid fast staining of (sputum, gastric aspirate, pleural fluid), CSF routine & micro in case of TB meningitis, pleural fluid
\nroutine & micro in cases of TB pleural effusion. DNA PCR and ADA level of body fluids (CSF, pleural fluid, blood) were done.
\nRESULTS
\nAmong the 50 patients of tuberculosis, 30 patients were diagnosed with TB meningitis. In these Tb Meningitis cases, 2 patients
\nwere positive for DNA PCR & 18 patients had high ADA level. Of the 15 patients of tubercular pleural effusion, one patient was
\nDNA PCR positive and 10 patients had high ADA level. In 5 patients of pulmonary tuberculosis, 1 patient tested positive for DNA
\nPCR and 3 patients for high ADA level.
\nCONCLUSION
\nOur results show that, neither PCR nor ADA activity should be relied on as a single test that substitutes for the diagnostic
\nmethods already available, but rather they should be used as an extra tool in the diagnosis of TB. The combined analysis of
\nPCR and ADA activity, however, is a very useful diagnostic approach to achieve a more rapid and precise diagnosis in the cases
\nof tuberculosis.