DIAGNOSIS OF TUBERCULOUS ASCITIES;

Role of polymerase chain reaction and adenosine deaminase activity

Abstract

Diagnosing Tuberculous ascites is a challenge. Polymerase chain reaction (PCR) and adenosine deaminase activity
(ADA) have come up as promising modalities to aid diagnosis of tuberculosis in body fluids. Objective: To find and compare the
usefulness of ADA and PCR in ascitic fluid in diagnosis of peritoneal tuberculosis. Study Design: A cross-sectional study. Place of Study:
Medical Unit-I, Ghulam Mohammad Mahar Medical College Hospital, Sukkur. Duration of Study: From January 2010 to July 2011.
Methods: Fifty five patients of exudative ascites, were diagnosed as peritoneal tuberculosis by following criteria- clinical suspicion, PPD
(Skin Tuberculin test) positive, suggestive bacteriological and/or imaging findings and ascitic fluid showing lymphocytosis with
decreased glucose and SAAG (Serum- Ascites albumin gradient) of <1.1 gm/ dL. PCR and ADA were performed in the ascitic fluid and
positivity rates determined and compared. Results: Out of 55 study subjects, 50 patients (90.9%) were PCR positive and 48 (87.3%)
were ADA positive; both were equiefficacious (p=0.54). High agreement between PCR and ADA tests was noted. Conclusions: ADA and
PCR are comparable as diagnostic modality for tuberculous peritonitis, however ADA scores over PCR because of easy availability, low
cost, less infrastructure requirement and less-time consuming.