Year : 2019 | Volume : 7 | Issue : 2 | Page : 41 - 44  

Original Articles
To Assess Diagnostic value of Lymphocyte // Neutrophil ratio and Adenosine Deaminase in the Diagnosis of Exudative Tubercular Pleural Effusion

K. Raj Kumar 1, Raghu Vamsi 2, Soumya Rani 3*

1 Associate Professor, 2, 3 Junior Resident, Department of Pulmonary Medicine, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar

*Corresponding Author

Dr. Soumya Rani                                                                                                                 



Background: Adenosine deaminase (ADA) is considered a valuable tool in the diagnosis of extra pulmonary tuberculosis.

Objective: To evaluate the role of ADA and L/N ratio in the diagnosis of tuberculous pleural effusion in patients with exudative pleural effusion and to analyze the cause of non tuberculous exudative pleural effusion.

Methods:  This hospital based prospective study was conducted from November 2017 to November 2018 with a total number of 100 patients of exudative pleural effusion who were admitted in medical wards of Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar, India. Patients with transudative pleural effusion, age less than 12years and those who were hemodynamically unstable were excluded from the study.

Results: A total of 100 patients with exudative pleural effusion were analyzed, of which 69 were males and 31 females.  maximum number of cases were seen in age group between 21 and 40 yrs. Total ADA was found to be >40U/L in all cases of TB effusion. All cases of TB effusion were lymphocyte predominant with L/N ratio > 0.75. In case of exudative pleural effusion due to non tuberculous etiology L/N ratio was < 0.75.

Conclusion: 100 cases of exudative pleural effusion were analyzed based on Total ADA and L/N ratio. 80 cases were due to tuberculosis. ADA value of >100 U/L was observed only in tuberculous effusion. L/N ratio was >0.75 in 80 cases of TB effusion and in none of the non tuberculous effusion. Combined use of ADA and L/N ratio is more efficient means for diagnosing tubercular pleural effusion than the use of ADA alone.

Keywords: Adenosine deaminase, lymphocyte/neutrophil ratio, exudative pleural effusion, transudative pleural effusion.


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