The Diagnostic Accuracy of Pleural Fluid Lactate Dehydrogenase to Adenosine Deaminase ratio in Pleural Tuberculosis
Abstract
To determine diagnostic accuracy of the pleural fluid lactate dehydrogenase to adenosine deaminase ratio in diagnosis of pleural tuberculosis.
The study was conducted at “Department of the Pulmonology, Mayo Hospital, Lahore from 01-03-2025 to 31-08-2025.Ethical approval was obtained before enrolling 63 Pulmonology outpatients who met the selection criteria. All participants gave Informed consent before participation. Patient data, including name, age, gender, BMI, symptom duration, and medical history (e.g., diabetes, hypertension, smoking, tuberculosis), were recorded. Pleural fluid was collected via thoracentesis by a research team. The sample was divided into two sterile containers: one for LDH and ADA testing, and the other for culture. Pleural tuberculosis was diagnosed with an LDH/ADA ratio <10. Culture results were documented after 4-6 weeks. Data analysis was conducted using SPSS 28.
We found mean age of 42.22±16.56 years. The majority of participants were male (60.3%, n=38), while females constituted 39.7% (n=25) of the study population. Based on LDH/ADA ratio, 76.2% tested positive and 23.8% negative. Culture report confirmed 77.8% positive and 22.2% negative. Using culture as the reference, the LDH/ADA ratio showed sensitivity of 95.92%, specificity of 92.86%, PPV 97.92%, NPV 86.67%, and overall accuracy of 95.24%.
Pleural fluid LDH/ADA ratio was found to be comparable to pleural fluid mycobacterial culture in diagnosing pleural tuberculosis.
How to Cite This Article
Ikram A, Younus M, Abbas R, Nadeem HMF, Cheema A, Saeed A. The Diagnostic Accuracy of Pleural Fluid Lactate Dehydrogenase to Adenosine Deaminase ratio in Pleural Tuberculosis. J Pak Soc Intern Med. 2026;7(3):232–237. doi:10.70302/jpsim.v7i3.2644
Conflict of Interest
The authors declare no conflict of interest.
Funding
This research received no specific grant from any funding agency.
Funder information follows the Crossref Funder Registry standard.
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