The pleural fluid lactate dehydrogenase /adenosine deaminase and pleural fluid adenosine deaminase /serum C-Reactive Protein ratios for differentiating between Tuberculosis and other causes in a sample of Iraqi patients

Objectives: This study aim is to evaluate the importance of pleural fluid LDH/ADA ratio and pleural fluid ADA/serum CRP ratio in differentiating tuberculous pleural effusion from other causes in a sample of Iraqi patients. Methods: A prospective study of 100 patients with pleural effusion whom age ranges from 18-70 years where admitted at medical department at Al-Imamein Kadhimein medical city in Bagdad and in Marjan and Al-Sadik hospitals at Babylon province. Out of 61(61%) are males and 39 (39%) are females. The study period was 9 months started from 1st of February to End of October 2019. Results: in this study the result of comparison of mean level of pleural fluid LDH/ADA ratio and pleural fluid ADA/Serum CRP ratio between tuberculous and para pneumonic pleural effusions were significant =0.025 and 0.002 respectively. Also the comparison of pleural fluid LDH /ADA ratio and pleural fluid ADA/Serum CRP ratio between tuberculous and malignant pleural effusions were significant =0.005 in both. Conclusion: Pleural fluid LDH /ADA ratio is of great value in differentiation tuberculous pleural effusion from malignant pleural effusion with predominant lymphocytes, pleural fluid ADA/serum CRP ratio is of great value in differentiation tuberculous pleural effusion from para pneumonic pleural effusion with elevated pleural fluid ADA and elevated serum CRP.