Lucena AC, Antonangelo L, Da Mata V, Pacciolo E, Costa SF, Caiaffa HH; American Society for Microbiology. General Meeting.
Abstr Gen Meet Am Soc Microbiol. 1999 May 30-Jun 3; 99: 637 (abstract no. U-21).
Hospital das Clinicas Sao Paulo, Brazil.
The diagnosis of Pleural Tuberculosis is based on time consuming methods that create difficulties for the immediate start of the therapy. The PCR is already standardized for respiratory samples but little is know about its performance with Pleural effusions. The objective of this study is to evaluate the utility of the PCR in the diagnosis of Pleural Tuberculosis adapting a know PCR technology already well established. Materials and Methods: Sample of Pleural effusion from 44 patients were studied using the PCR MTB Amplicor (Roche Diagnostics Systems, Sommerville, NJ) and dosing ADA (adenosine deaminase) with the modified Giusti method (cut off > 40 U/L). Culture results of Pleural effusion, pleural fragments and pleural biopsy were used as gold standard for the definitive diagnosis. Results: From the 44 patients studied, 17 had Pleural tuberculosis, 10 were culture positive (9 pleural effusion culture and 1 pleural fragments culture) and 15 presented positive pleural biopsy (for 2 patient a biopsy was not done). The PCR was positive for 15/44 patients while 12 had certain diagnostic. The sensibility of method was 70% and the specificity was 89%. The PPV was of 80% and NPV was of 82%. ADA values in the culture positive cases varied from 19 to 127.5 U/L (88% with ADA>40U/L) in the cases with positive biopsy from 70 to 323 U/L. In controls (negative culture and/or biopsy) the ADA varied from 5.6 to 98 U/L being 20% above 40U/L. The overall ADA sensibility was 94% and the specifity 68%. The PPV=66% and the NPV=94%. Conclusion: The PCR demonstrated to be a specific method that is fast in the Pleural tuberculosis diagnostic. When associated with ADA it can anticipate the certain diagnostic allowing for an early therapy start.
Publication Types:
Keywords:
- Adenosine Deaminase
- Exudates and Transudates
- Humans
- Pleura
- Pleural Effusion
- Polymerase Chain Reaction
- Sensitivity and Specificity
- Tuberculosis, Pleural
- diagnosis
- methods
- therapy
Other ID:
UI: 102195780
From Meeting Abstracts