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Adenosine Deaminase in the Diagnosis of Tuberculous Pleural Effusion : Is It Really an Ideal Test? A Word of Caution

Rafael Laniado-Laborín, MD, MPH, FCCP
Author and Funding Information

Affiliations: San Ysidro, CA
 ,  Dr. Laniado-Laborín is affiliated with the Facultad de Medicina Tijuana, Universidad Autonoma de Baja California, México.

Correspondence to: Rafael Laniado-Laborín, MD, MPH, FCCP, PMB 953, 482 W San Ysidro Blvd, No. 2, San Ysidro, CA 92173; e-mail: rafaellaniado@hotmail.com



Chest. 2005;127(2):417-418. doi:10.1378/chest.127.2.417
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A definite diagnosis of tuberculous pleural effusion (TPE) can be difficult to make because of the low sensitivity and/or specificity of noninvasive traditional diagnostic tools. In most series of patients with TPE, the results of pleural fluid staining for acid-fast bacilli are virtually always negative, and pleural fluid cultures are positive for mycobacteria in < 25% of cases. On the other hand, a pleural biopsy specimen will demonstrate granulomatous pleuritis in 80% of patients with TPE, and when a culture of a biopsy specimen is combined with histologic examination, the diagnosis can be established in approximately 90% of cases.1

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