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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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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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