Diagnostic Accuracy with Total Adenosine Deaminase as a Biomarker for Discriminating Pleural Transudates and Exudates in a Population-Based Cohort Study

Background An initial step in the evaluation of patients with pleural effusion syndrome (PES) is to determine whether the pleural fluid is a transudate or an exudate. Objectives To investigate total adenosine deaminase (ADA) as a biomarker to classify pleural transudates and exudates. Methods An assay of total ADA in pleural fluids (P-ADA) was observed using a commercial kit in a population-based cohort study. Results 157 pleural fluid samples were collected from untreated individuals with PES due to several causes. The cause most prevalent in transudate samples (21%, n = 33/157) was congestive heart failure (79%, 26/33) and that among exudate samples (71%, n = 124/157) was tuberculosis (28.0%, 44/124). There was no significant difference in the proportion of either sex between the transudate and exudate groups. The median values of P-ADA were significantly different ( P P P P Conclusions P-ADA is a useful biomarker for distinguishing pleural exudates from transudates.