Diagnostic value of ADA in Tuberculosis: a comparative study performed in Jammu, India

  • Kuldeep Singh Govt Medical College,Jammu
  • Gousia Rahim
Keywords: Serum ADA, Pulmonary Tuberculosis, Mantoux Test, Sputum AFB, Chest X-ray


Background: Diagnosis of Tuberculosis in patients is usually made by clinical, radiological and laboratory investigations including the biochemical test of measuring serum Adenosine deaminase activity (ADA). Present study aims at finding usefulness of serum ADA in pulmonary tuberculosis.Methods: The study was carried out on 100 patients suffering from pulmonary tuberculosis by taking history, physical examination and investigations including three consecutive (spot-early morning) sputum sample examination, Mantoux test, posteroanterior chest X-ray, ESR by westergren method and estimation of serum ADA activity. Comparative evaluation of these investigations was made and usefulness of detecting serum ADA was established in pulmonary tuberculosis.Result: Out of 100 patients of pulmonary tuberculosis, serum ADA level was raised in 90 (90%) cases while Mantoux test was positive in 80 (80%) cases, chest X- ray was suggestive in 75 (75%) cases, ESR was raised in 70 (70%) cases and sputum AFB was positive in 64 (64%) cases.Conclusion: Study of isoenzyme ADA is quite helpful in differentiating tuberculous and non-tuberculous etiology. Moreover being cost effective and less time consuming it should be done routinely as aid for diagnosis of tuberculosis.

Author Biography

Kuldeep Singh, Govt Medical College,Jammu
Professor Of PathologyGovt Medical College,Jammu


1. Ungerer JP, Oosthuizen HM, Retief JH, Biss-bort SH. Significance of adenosine deaminase activity and its isoenzymes in tuberculous effusions. Chest 1994;106:33-7.
2. Collazos J, Espana P, Mayo J, Martinez E, Izquierdo F. Sequential evaluation of serum adenosine deaminase in patients treated for tuberculosis. Chest 1998;114:432-5.
3. Thora S, Rajsekaran P, Chhaparwal BC. Serum adenosine deaminase estimation in relation to BCG vaccination. Indian Pediatr 1995;32: 1087-8.
4. Mishra OP, Yusaf S, Ali Z, Nath G, Das BK. Adenosine deaminase activity and lysozyme levels in children with tuberculosis. J Trop Pediatr 2000;46:175-8.
5. Ishii S, Nagasawa H, Tai H, Noda Y, Akiyama K, Takeda H, et al. [Relationship between the activity of serum adenosine deaminase including its isozymes and lymphocyte subpopulation in patients with pulmonary tuberculosis] Kekkaku 1997; 72:153-9. Japanese.
6. Murray PR, Elmore C, Krogstad DJ. The ac-id-fast stain: a specific and predictive test for mycobacterial disease. Ann Intern Med 1980; 92:512-3.
7. Gakis C, Ortu AR, Contu A, Bechere M. Adenosine deaminase activity in the diagnosis of infectious diseases. Infect Med.1994; 219- 224.
8. Klockars M, Kleemola M, Leinonen M, Koskela M. Serum adenosine deaminase in viral and bacterial pneumonia. Chest 1991; 99: 623-6.
9. Conde MB, Marinho SR, Pereira Mde F, Lapa e Silva JR, Saad MH, Sales CL, et al. The usefulness of serum adenosine deaminase 2 (ADA2) activity in adults for the diagnosis of pulmonary tuberculosis. Respir Med 2002; 96: 607-10.
10. Yasuhara A, Nakamura M, Shuto H, Kobayashi Y. Serumadenosine deaminase activity in the differentiation of respiratory diseases in children. Clin Chim Acta 1986; 161: 341-5.
11. Piras MA. Immunological studies in Mediter-ranean spotted fever. Lancet. 1982; 1:1249.
12. Giblett ER, Anderson IE, Cohen F, Pollara B, Mellcuissen J. ADA dificency in two patients with severly impaired cellular immunity. Lancet; 1972, 22: 1067.
Original Article