A CORRELATIVE STUDY OF ADENOSINE DEAMINASE ACTIVITY & T.B. IgG IN SERUM IN CASES OF TUBERCULOSIS.

INTRODUCTION:Tuberculosis is major cause of morbidity and mortality in India as well in other parts of world.It is caused by mycobacterium tuberculosis which primarily affects lung and cause pulmonary tuberculosis.Diagnosis of tuberculosis rests upon a positive history of contact, clinical symptoms, x-ray chest, sputum positivity and AFB culture.Adenosine deaminase (ADA) is an enzyme which catalyzes the deamination of adenosine into inosine and ammonia.ADA level is found to be elevated in tuberculosis and typhoid fever where cell mediated immunity is elevated.The ADA level is significantly elevated in tuberculosis and helps to differentiate between tubercular and non tubercular diseases.The ADA level is also found to be elevated in serum and pleural fluid in patients of tubercular pleural effusion, tubercular ascitis and tubercular pericardial effusion.METHODS: Routine hemogram, Montoux test, X-ray chest, FNAC of lymph nodes, biopsy of lymph node whenever required, estimation of serum ADA level and T.B.IgG studies were performed in each case.RESULTS: In the present study a total of 45 cases were selected for the study.There are 30 cases of pulmonary tuberculosis and 15 controls.The values of serum ADA and tubercular IgG in pulmonary tubercular group are significantly higher as compared to those of controls.None of the control for ADA showed significant ratio of positivity (≥1.7).One of the 15 cases showed remarkable ratio of positivity (>1.2-1.6) and 14 (93.3%)cases showed insignificant ratio of positivity.Only 2 (13.33%) of the 15 cases showed positivity for TB IgG and rest 13 (86.66%)were regarded negative.CONCLUSIONS: Thus it can be concluded that determination of serum adenosine deaminase levels can effectively diagnose tuberculosis with sensitivity of 96.66% and specificity of 93.33% as compared to TBIgG showing sensitivity of 90% and specificity of 86.6%.Also cost of ADA estimation is remarkably less than that of tubercular IgG KEY WORDS: Serum ADA, T.B.IgG levels, Tuberculosis INTRODUCTION: Tuberculosis is major cause of morbidity and mortality in India as well in other parts of world.It is caused by mycobacterium tuberculosis which primarily affects lung and cause pulmonary tuberculosis.It can also affect intestine, bones, joints, lymph nodes, genitourinary system, skin and virtually every organ of the body.