Diagnostic accuracy of adenosine deaminase in GeneXpert positive tuberculosis pleural effusion.

<bold>Introduction:</bold> Early diagnosis is very important for management of tuberculosis pleural effusion. Along with different diagnostic tests, raised adenosine deaminase level in pleural effusion is also used for diagnosis of tuberculous pleural effusion. <bold>Objective:</bold> To determine diagnostic accuracy of adenosine deaminase in predicting tuberculosis pleural effusion taking GeneXpert as gold standard. <bold>Subject and methods:</bold> This is a cross section study conducted at Ojha institute of chest diseases, Dow university of health sciences Karachi, Pakistan from 20-05-2021 to 19-11-2021. This study includes 212 patients selected by non probability consecutive sampling technique. All patients who fulfilled inclusion criteria and detailed demographic and medical history of each patient was obtained. Pleural fluid was obtained from pleural cavity with needle and syringe by using local anaesthetic and sample was sent to laboratory for adenosine deaminase level and GeneXpert. All the obtained data was recorded in attached proforma and analyzed by using SPSS v 22. <bold>Results:</bold> Out of 212 patients recruited, 135(63.7%) patients were male and 77(36.3%) were female, with mean age of 42.8_+ 12.24 (18-60) years. TPE diagnosed in 143(67.5%) patients on the basis of ADA and in 137(64.6%) on the basis of GeneXpert. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of ADA was 90.6%, 74.7%, 86.8%, 81.2% and 85.0% respectively by taking GeneXpert as gold standard. <bold>Conclusion:</bold> Adenosine deaminase is sensitive and specific in detection of pleural effusion. The diagnostic accuracy of ADA in detection of tuberculosis pleural effusion is acceptable and can be as alternative for GeneXpert.