To study the diagnostic yield of pleural fluid adenosine deaminase (ADA) combined with Lymphocytic/Neutrophil (L/N) ratio in tubercular pleural effusion at a tertiary care center

Introduction: Tuberculosis is one of the leading causes of death worldwide and tubercular pleural effusion is the second most common form of extrapulmonary tuberculosis after lymph node tuberculosis. The most commonly used method to diagnose exudative pleural effusion is by the help of Light’s Criteria. The goal of our study was to search for another diagnostic tool that may have a better diagnostic yield for diagnosing pleural effusion than the present methods. Material and Methods: A prospective observational study was conducted in the pulmonary medicine department of a tertiary care center over a period of 18 months, where patients with pleural effusion were enrolled in the study after proper informed consent. These effusion cases were differentiated among tubercular and non-tubercular groups by recognized methods. Among these cases, the non-tubercular patients were taken as controls. Results: A total of 45 cases were taken after considering the inclusion and exclusion criteria, with 30 tubercular effusion cases and 15 controls. The sensitivity and specificity of combined ADA & LNR were calculated to be 94.4% with a test accuracy of 89.29%. Conclusion: Our study concludes, that tubercular pleural effusion contributes substantially to the burden of disease in the world including in India.