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The Journal of Cardiovascular Surgery 1999 August;40(4):501-4

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Diag­nostic ­value of aden­o­sine deam­i­nase activity in per­i­car­dial ­fluids

Dogan R., Demircin M., Sarigul A., Ciliv G., Bozer A. Y.

From the Depart­ment of Tho­racic and Car­di­o­vas­cular Sur­gery Ha­cet­tepe Uni­ver­sity, ­Faculty of Med­i­cine, Ankara, ­Turkey


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Back­ground. The ­activity of aden­o­sine deam­i­nase (ADA) was deter­mined in ­serum and per­i­car­dial ­fluid of 70 ­patients (­ages 21 to 71 ­years) ­with per­i­car­dial effu­sions of var­ious eti­ol­o­gies and in 15 con­trol sub­jects.
­Methods. The ­patients ­were sub­di­vided ­into ­five ­groups on the ­basis of def­i­nite diag­nosis: 1) 24 ­patients ­with tuber­cu­losis; 2) 22 ­with malig­nan­cies; 3) 12 ­with ­uremic per­i­car­ditis; 4) 12 ­with puru­lent per­i­car­ditis; 5) 15 con­trol indi­vid­uals ­without per­i­car­dial dis­ease. The ­activity of ADA was deter­mined at the ­same ­time in ­serum and ­cell-­free per­i­car­dial ­fluid ­according to the ­method of ­Karker ­with ­minor mod­ifi­ca­tion.
­Results. ­Mean (±SD) ADA ­activity in per­i­car­dial ­fluid was 66.92±4.12 IU/L in ­group 1; 27.50±6.02 in ­group 2; 28.65±4.73 in ­group 3; 53.05±11.14 in ­group 4; and 5.67±1.99 in ­group 5. Com­paring the ­level ­achieved in ­group 1 ­with all ­others, the dif­fer­ence is sig­nif­i­cant at the p<0.001 ­level. ­When the cut-off ­value of 50 IU/L is ­used the sen­si­tivity of the ­test for diag­nosis of tuber­cu­lous effu­sion is 1, and the spec­i­ficity is 0.83. Sta­tis­tical anal­ysis ­showed ­that ­there was no cor­re­la­tion ­between ­serum ADA ­activity and ADA ­activity in per­i­car­dial ­fluid.
Con­clu­sions. We rec­om­mend ­that deter­mi­na­tions of ADA ­activity in path­o­logic per­i­car­dial ­fluids ­seem to be of ­great ­value in the ­early diag­nosis of tuber­cu­lous per­i­car­dial effu­sions. ­Levels ­above 50 IU/L in effu­sions indi­cate prob­able tuber­cu­losis.

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