Diagnostic utility of ADA and CBNAAT in tubercular pleural effusion

TL;DR

The study shows that combining ADA and CBNAAT tests improves the accuracy of diagnosing tubercular pleural effusion.

Contribution

The study demonstrates that combining ADA and CBNAAT tests enhances diagnostic accuracy for tubercular pleural effusion.

Findings

CBNAAT is highly specific but has limited sensitivity for diagnosing TPE.

ADA levels ≥40 IU/L show strong sensitivity for TPE diagnosis.

Combining ADA and CBNAAT improves diagnostic accuracy and reduces invasive procedures.

Abstract

The diagnostic performance of Adenosine Deaminase (ADA) and Cartridge-Based Nucleic Acid Amplification Test (CBNAAT) in diagnosing
tubercular pleural effusion (TPE) is of interest. Hence, a study was conducted over 18 months at LN Medical College and JK Hospital,
Bhopal. The study involved 108 adult patients with TPE. Data shows that CBNAAT, although highly specific, had limited sensitivity,
while ADA ≥40 IU/L demonstrated strong sensitivity. ADA levels were significantly higher in CBNAAT-positive participants, suggesting
that combining both tests enhances diagnostic accuracy. This approach can help reduce the need for invasive procedures and improve
timely treatment, especially in resource-limited settings. We show the importance of using ADA and CBNAAT together in the diagnosis of
TPE.