Tuberculous Pleurisy: the role of the ADA Enzyme in Diagnosis and Treatment Outcomes

Extrapulmonary TB, representing nearly 15% of the global TB burden, is more difficult to diagnose. Tuberculous pleural effusion (TPE), one of the commonest forms of extrapulmonary TB, is a diagnostic challenge with rather poor microbiologic confirmation rates from pleural fluid analysis2,3. Even diagnostic tools like CBNAAT and interferon-gamma release assays have shown suboptimal diagnostic accuracy4,5. Adenosine deaminase (ADA), an enzyme produced from lymphocytes and involved in purine metabolism, has been extensively studied as a biochemical marker in pleural fluid during investigation for TPE. The test is simple, cheap, rapid, minimally invasive, and can be performed in most laboratories3.