Avaliação da atividade da adenosina deaminase no derrame pleural tuberculoso

Introduction: Tuberculosis (TB) is a major global health problem and requires special attention from health professionals and society as a whole. Among the extrapulmonary forms, pleural TB stands out as the most common cause of pleural effusion (PE). To perform a differential diagnosis between tuberculous and non-tuberculous PE is a critical clinical problem, since the conventional methods are not always useful in diagnosis, because they present limitations. Adenosine deaminase (ADA) is an enzyme found mainly in lymphocytes, directly related to the activation of these cells and plays an important role in the immune system. Objective: To verify the activity of ADA in pleural effusion of patients treated at the University Hospital of Santa Maria, to aid in the diagnosis of pleural TB, as well as the relationship of the enzyme with biochemical parameters routinely performed in pleural fluid as protein, glucose and lactate dehydrogenase activity (LDH). Methods: Through a retrospective study, it was analyzed 200 medical records of patients admitted with pleural effusion from December 2008 to December 2011. Statistical analyses was performed by non-parametrical tests, Kruskal - Wallis and Pearson correlation, the data were expressed as median (25% e 75% percentis) and a p value <0.05 was considered significant. Results: The activity of ADA in pleural fluid was found to be increased in patients with tuberculous PE. Furthermore, the enzyme activity was positively correlated with the levels of protein and LDH among the general population involved in the study. Conclusion: The determination of ADA activity is a precise procedure with good sensitivity and can be suggested as an important marker of tuberculosis PE, which could aid in the differential diagnosis of the disease.