Pande Putu Ayu Patria Dewi, Aryati Aryati, Leonita Anniwati, Isnin Anang Marhana


Pleural effusion is an abnormal accumulation of fluid in the pleural space resulting from increased production of fluid or decreased resorption of fluid in the pleural space. Pleural effusion can be caused by infectious diseases, malignancies, collagen disease, gastrointestinal disease, heart disease and other causes such as medication. Adenosine Deaminase (ADA) is an enzyme involved in the catabolism of purines. This enzyme can be measured in pleural fluid, serum and other body fluids such as cerebrospinal and ascites fluid. The aim of this study was to analyze the correlation between adenosine deaminase activity in pleural fluid and serum in patients with pleural effusion. This research was an observational study with a cross-sectional design. Examination of ADA activity was performed in pleural fluid and serum. Adenosine deaminase activity was examined using photometric methods (Non-Giusti), using Diazyme reagent by TMS 24i Premium. Subjects were 46 patients with pleural effusion caused by malignancies, tuberculosis and systemic diseases. Mean±SD ADA activity for all pleural effusion samples in serum was 13.037± 8.365 (0.5-34.1) U//L and pleural fluid 30.843± 28.860 U//L (1.3-140.8). No correlation between ADA activity in serum and pleural fluid (r=0.173, p= 0.252) was found in all samples. No correlation between ADA activity in serum and pleural fluis was found in malignancies (r=0.109, p=0.630), tuberculosis (r= 0.366, p=0.123), systemic diseases (r =0.466, p=0.429) and non-tuberculosis group (r=0.126, p=0.532). There was no correlation between pleural fluid ADA activity and serum.



Adenosine deaminase, pleural fluid, serum, correlation

Full Text:



Hooper C, Lee YC, Maskell N. Investigation of a unilateral pleural effusion in adults: British Thoracic Society pleural disease guideline 2010. In: Thorax, 2010; 65(2): 4 – 17.

Sato T. Differential Diagnosis of Pleural Effusion. In: JMAJ, 2006; 49(9): 315-19.

Khan FY, Alsamawi M, Yasin M, Ibrahim AS, Hamza M, et al. Etiology of pleural effusion among adults in the State of Qatar: a 1-year hospital-based study. In: EMHJ, 2011; 17(7): 611-18.

Najib MR. Local anesthetic thoracoscopy: British Thoracic Society pleural disease guideline 2010. In: Thorax, 2010; 65(2):54-i60.

Barua R, Hossain M. Adenosine Deaminase in Diagnosis of Tuberculosis: A Review. In: AKMMC Journal, 2014; 5(2): 43-48.

Liang QL, Shin HZ,Wang K, Qin Sm, et al. Diagnostic accuracy of adenosine deaminase in tuberculous pleurisy: A meta-analysis. In: Respiratory Medicine, 2008;102:744 –754.

Salmanzadeh S, Tavakkol H, Bavieh K, Alavi S.M., 2015. Diagnostic Value of Serum Adenosine Deaminase (ADA) Level for Pulmonary Tuberculosis. In: Jundishapur J Microbiol, 2015; 8(3): 2-5.

Verma S. Role of pleural fluid adenosine deaminase in aetiological diagnosis of pleural effusion. In: The Internet Journal of Infectious Diseases, 2008; 7(1): 1-4.

Kusuma C, Anniwati L, Pradjoko, I. Korelasi antara Aktivitas Adenosine Deaminase dan Hasil Analisis Cairan Pleura pada Penderita Curiga Efusi Pleura Tuberkulosis. Surabaya, Universitas Airlangga. 2015; 6-63.

Ogunleye EO. Aetiology and Demographic Attributes of Common Pleural Collections in an African Population. In: Surgical Science, 2013; 4: 332-34.

Bhoumik SK.Evaluation of Adenosine Deaminase (ADA) Activity for Diagnosis of Tubercular Pleural Effusion. In: Bangladesh J Med Biochem, 2013; 6(2): 40-48.

Lamsal M,Gautam N, Bhatta N, Majhi S, et al. Diagnostic Utility of Adenosine Deaminase (ADA) Activity in Pleural Fluid, and Serum of Tuberculous and Non-tuberculous Respiratory Disease Patients. In: Southeast Asian J Trop Med Public Health, 2007; 38(2): 363-69.

Boonyagars L, Liertiburanakul S. Use of adenosine deaminase for the diagnosis of tuberculosis: a review. In: Journal of Infectious Disease, and Antimicrobial Agents, 2010; 27: 111-8.

Urunsak IF, Gulec UK, Paydas S, Seydaoglu G, Guzel AB, Vardar MA. Adenosine deaminase activity in patients with ovarian neoplasms. In: Arch Gynecol Obstet, 2012; 286(1): 155-59.

Aghaei M. Diagnostic Value of Adenosine Deaminase Activity in Benign and Malignant Breast Tumors. In: Archives of Medical Research, 2010; 41(1): 14-18.

Nariman AH, Eissa SA, Masaoud HH, Elessawy. Diagnostic value of adenosine deaminase in tuberculous and malignant pleural effusion. In: Egyptian Journal of Chest Diseases, and Tuberculosis, 2012; 61(4): 413-17.



  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.