Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Oct 7, 2012; 18(37): 5260-5265
Published online Oct 7, 2012. doi: 10.3748/wjg.v18.i37.5260
Adenosine deaminase activity in tuberculous peritonitis among patients with underlying liver cirrhosis
Yi-Jun Liao, Chun-Ying Wu, Shou-Wu Lee, Chia-Ling Lee, Sheng-Shun Yang, Chi-Sen Chang, Teng-Yu Lee
Yi-Jun Liao, Chun-Ying Wu, Shou-Wu Lee, Sheng-Shun Yang, Chi-Sen Chang, Teng-Yu Lee, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407, Taiwan, China
Chun-Ying Wu, Teng-Yu Lee, Graduate Institute of Clinical Medical Science, China Medical University, Taichung 407, Taiwan, China
Shou-Wu Lee, Sheng-Shun Yang, Chi-Sen Chang, Teng-Yu Lee, Department of Medicine, Chung Shan Medical University, Taichung 407, Taiwan, China
Chia-Ling Lee, Medical Record Room, Taichung Veterans General Hospital, Taichung 407, Taiwan, China
Author contributions: Liao YJ, Wu CY and Lee TY designed this study; Lee CL provided data from medical records; Lee SW and Yang SS collected clinical data; Chang CS provided executive support for this work; and Liao YJ and Lee TY wrote the manuscript.
Correspondence to: Dr. Teng-Yu Lee, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, 160, Section 3, Taichung Harbor Road, Taichung 407, Taiwan, China. tylee@vghtc.gov.tw
Telephone: +886-4-23592525 Fax: +886-4-23741331
Received: April 3, 2012
Revised: May 29, 2012
Accepted: June 8, 2012
Published online: October 7, 2012
Abstract

AIM: To investigate the value of adenosine deaminase (ADA) for early detection of tuberculous peritonitis (TBP) among cirrhotic patients.

METHODS: We retrospectively analyzed 22 patients with TBP from July 1990 to June 2010. Twenty-five cirrhotic patients with uninfected ascites were prospectively enrolled as the cirrhosis control group from July 2010 to June 2011. An additional group of 217 patients whose ascites ADA levels were checked in various clinical conditions were reviewed from July 2008 to June 2010 as the validation group.

RESULTS: The mean ascites ADA value of cirrhotic patients with TBP (cirrhotic TBP group, n = 8) was not significantly different from that of non-cirrhotic patients (non-cirrhotic TBP group, n = 14; 58.1 ± 18.8 U/L vs 70.6 ± 29.8 U/L, P = 0.29), but the mean ascites ADA value of the cirrhotic TBP group was significantly higher than that of the cirrhosis control group (58.1 ± 18.8 U/L vs 7.0 ± 3.7 U/L, P < 0.001). ADA values were correlated with total protein values (r = 0.909, P < 0.001). Using 27 U/L as the cut-off value of ADA, the sensitivity and specificity were 100% and 93.3%, respectively, for detecting TBP in the validation group.

CONCLUSION: Even with lower ADA activity in ascites among cirrhotic patients, ADA values were significantly elevated during TBP, indicating that ADA can still be a valuable diagnostic tool.

Keywords: Extrapulmonary; Tuberculosis; Ascites; Cirrhosis; Peritonitis