Adenosina deaminasi nella diagnosi di infezione tubercolare

We valued the role of Adenosine Deaminase Activity(ADA) in pleural effusion fluid and in liquoral samples for the diagnosis of tubercular infection.In the last 25 years in Italy the TB has manteined a stable frequency. More cases are observed in risk and age category and frequently are observed multi or extensively drug resistant strains. This trend is due to HIV/AIDS patients and immigrant cases. The possibility to acquire TB by international travellers is demonstrated.BK kills more than 1800000/year people in the world, the majority in African high HIV infected areas and in Asia.In the last years an increment of extrapulmonary forms has been observed: CNS infection and pleuritis due to BK are predominant forms. The diagnosis in these cases is often difficoult: a part of complex clinical features, sometimes with a rapid and dramatic progression, the laboratory tests could be negative or late.We valued ADA detection as marker of tubercular infection.We modified the first Giusti/Gakis colorimetric method.We analyze 128 pleural fluid and 124 CSF samples. Our test demonstrate a Sensibility of 100% and a Sensibility between 82% and 97%.The test is rapid (2 h), cheap (< 1 € ) and easy to do.A negative result virtually excludes the TB. The rapidity and sensibility are usefull to start early a specific treatment.We think that the ADA dosage could be used also in development countries where the diagnosis of extrapulmonary TB often has not any support by the laboratory.