Javed Ahmed Phulpoto.
Diagnosis of tuberculous ascities; role of polymerase chain reaction and adenosine deaminase activity.
Professional Med J Jan ;20(3):381-4.

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.

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