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. 1995 Mar;36(3):419–421. doi: 10.1136/gut.36.3.419

Ascitic fluid gamma interferon concentrations and adenosine deaminase activity in tuberculous peritonitis.

M A Sathar 1, A E Simjee 1, Y M Coovadia 1, P N Soni 1, S A Moola 1, B Insam 1, F Makumbi 1
PMCID: PMC1382457  PMID: 7698702

Abstract

The gamma interferon (gamma-IFN) concentration and the adenosine deaminase (ADA) activity were evaluated in 30 patients with tuberculous peritonitis, 21 patients with ascites due to a malignant disorder, and 41 patients with cirrhosis. The gamma-IFN concentrations were significantly higher (p < 0.0001) in tuberculous peritonitis patients (mean: 6.70 U/ml) than in the malignant (mean: 3.10 U/ml) and cirrhotic (mean: 3.08 U/ml) groups. Use of a cut off value of > or = 3.2 U/ml gave the assay a sensitivity of 93% (25 of 27), a specificity of 98% (54 of 55), positive (P+) and negative (P-) predictive values of 96% and a test accuracy of 96%. The ADA activity was significantly (p < 0.0001) higher in the tuberculous peritonitis group (mean: 101.84 U/l) than in the control groups (cirrhosis (mean: 13.49 U/l) and malignancy (mean: 19.35 U/l)). A cut off value of > 30 U/l gave the ADA test a sensitivity of 93% (26 of 28) a specificity of 96% (51 of 53), a (P+) value of 93%, a (P-) value of 96%, and a test accuracy of 95%. There was a significant (p < 0.0001) correlation (r = 0.72) between ADA activity and gamma-IFN values in patients with tuberculous peritonitis. These results show that a high concentration of gamma-IFN in ascitic fluid is as valuable as the ADA activity in the diagnosis of tuberculous peritonitis. Both are rapid non-invasive diagnostic tests for tuberculous peritonitis.

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Selected References

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  1. Bhargava D. K., Gupta M., Nijhawan S., Dasarathy S., Kushwaha A. K. Adenosine deaminase (ADA) in peritoneal tuberculosis: diagnostic value in ascitic fluid and serum. Tubercle. 1990 Jun;71(2):121–126. doi: 10.1016/0041-3879(90)90007-u. [DOI] [PubMed] [Google Scholar]
  2. Bhargava D. K., Shriniwas, Chopra P., Nijhawan S., Dasarathy S., Kushwaha A. K. Peritoneal tuberculosis: laparoscopic patterns and its diagnostic accuracy. Am J Gastroenterol. 1992 Jan;87(1):109–112. [PubMed] [Google Scholar]
  3. Blake J., Berman P. The use of adenosine deaminase assays in the diagnosis of tuberculosis. S Afr Med J. 1982 Jul 3;62(1):19–21. [PubMed] [Google Scholar]
  4. Fernandez-Rodriguez C. M., Perez-Arguelles B. S., Ledo L., Garcia-Vila L. M., Pereira S., Rodriguez-Martinez D. Ascites adenosine deaminase activity is decreased in tuberculous ascites with low protein content. Am J Gastroenterol. 1991 Oct;86(10):1500–1503. [PubMed] [Google Scholar]
  5. Geake T. M., Spitaels J. M., Moshal M. G., Simjee A. E. Peritoneoscopy in the diagnosis of tuberculous peritonitis. Gastrointest Endosc. 1981 May;27(2):66–68. doi: 10.1016/s0016-5107(81)73152-3. [DOI] [PubMed] [Google Scholar]
  6. Lingenfelser T., Zak J., Marks I. N., Steyn E., Halkett J., Price S. K. Abdominal tuberculosis: still a potentially lethal disease. Am J Gastroenterol. 1993 May;88(5):744–750. [PubMed] [Google Scholar]
  7. Manohar A., Simjee A. E., Haffejee A. A., Pettengell K. E. Symptoms and investigative findings in 145 patients with tuberculous peritonitis diagnosed by peritoneoscopy and biopsy over a five year period. Gut. 1990 Oct;31(10):1130–1132. doi: 10.1136/gut.31.10.1130. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Marshall J. B. Tuberculosis of the gastrointestinal tract and peritoneum. Am J Gastroenterol. 1993 Jul;88(7):989–999. [PubMed] [Google Scholar]
  9. Martin D. J., Schoub B. D., Miller G. B., Sim J. G. AIDS and tuberculosis. S Afr Med J. 1990 Nov 3;78(9):533–535. [PubMed] [Google Scholar]
  10. Martinez-Vazquez J. M., Ocaña I., Ribera E., Segura R. M., Pascual C. Adenosine deaminase activity in the diagnosis of tuberculous peritonitis. Gut. 1986 Sep;27(9):1049–1053. doi: 10.1136/gut.27.9.1049. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Menzies R. I., Fitzgerald J. M., Mulpeter K. Laparoscopic diagnosis of ascites in Lesotho. Br Med J (Clin Res Ed) 1985 Aug 17;291(6493):473–475. doi: 10.1136/bmj.291.6493.473. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Probert C. S., Jayanthi V., Wicks A. C., Carr-Locke D. L., Garner P., Mayberry J. F. Epidemiological study of abdominal tuberculosis among Indian migrants and the indigenous population of Leicester, 1972-1989. Gut. 1992 Aug;33(8):1085–1088. doi: 10.1136/gut.33.8.1085. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Ribera E., Español T., Martinez-Vazquez J. M., Ocaña I., Encabo G. Lymphocyte proliferation and gamma-interferon production after "in vitro" stimulation with PPD. Differences between tuberculous and nontuberculous pleurisy in patients with positive tuberculin skin test. Chest. 1990 Jun;97(6):1381–1385. doi: 10.1378/chest.97.6.1381. [DOI] [PubMed] [Google Scholar]
  14. Ribera E., Martínez Vásquez J. M., Ocaña I., Ruiz I., Jimínez J. G., Encabo G., Segura R. M., Pascual C. Diagnostic value of ascites gamma interferon levels in tuberculous peritonitis. Comparison with adenosine deaminase activity. Tubercle. 1991 Sep;72(3):193–197. doi: 10.1016/0041-3879(91)90007-f. [DOI] [PubMed] [Google Scholar]
  15. Ribera E., Ocaña I., Martinez-Vazquez J. M., Rossell M., Español T., Ruibal A. High level of interferon gamma in tuberculous pleural effusion. Chest. 1988 Feb;93(2):308–311. doi: 10.1378/chest.93.2.308. [DOI] [PubMed] [Google Scholar]
  16. Singh M. M., Bhargava A. N., Jain K. P. Tuberculous peritonitis. An evaluation of pathogenetic mechanisms, diagnostic procedures and therapeutic measures. N Engl J Med. 1969 Nov 13;281(20):1091–1094. doi: 10.1056/NEJM196911132812003. [DOI] [PubMed] [Google Scholar]
  17. Voigt M. D., Kalvaria I., Trey C., Berman P., Lombard C., Kirsch R. E. Diagnostic value of ascites adenosine deaminase in tuberculous peritonitis. Lancet. 1989 Apr 8;1(8641):751–754. doi: 10.1016/s0140-6736(89)92574-9. [DOI] [PubMed] [Google Scholar]
  18. al-Quorain A. A., Facharzt, Satti M. B., al-Freihi H. M., al-Gindan Y. M., al-Awad N. Abdominal tuberculosis in Saudi Arabia: a clinicopathological study of 65 cases. Am J Gastroenterol. 1993 Jan;88(1):75–79. [PubMed] [Google Scholar]

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