ArticleInfection2025
Diagnostic performance of adenosine deaminase for extrapulmonary tuberculosis in a higher-prevalence area of mainland France: a 10-year retrospective study.
Article in Infection, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Combining ADA, IFN-γ, and IL-6 as host biomarkers enhances diagnosis of paucibacillary and extrapulmonary tuberculosis.Communications medicine · 2026Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeDiagnosing extrapulmonary tuberculosis (EPTB) - including pleural, peritoneal, pericardial, meningeal forms - remains challenging due to the insufficient sensitivity of smear microscopy (SM), mycobacteriological culture, and nucleic acid amplification test (NAAT). The Adenosine Deaminase (ADA) assay has potential as a diagnostic tool for EPTB, but its performance in high-income countries is poorly documented. This study aimed to evaluate the diagnostic performance of ADA for microbiologically confirmed EPTB in such a setting.
methodsWe retrospectively analyzed data from all patients undergoing ADA testing in our hospital network in Paris area between May 2014 and April 2024. Microbiological confirmation (positive SM, culture, or NAAT) from the same sample site served as the reference standard.
resultsAmong 363 ADA assays (352 patients), 69% were pleural fluid, 18% peritoneal, < 1% pericardial, 11% CSF. For pleural fluid, ADA at a threshold of 30 U/L demonstrated 92% sensitivity (CI 80-98%), 75% specificity (CI 68-81%), 47% PPV (CI 37-57%), and 97% NPV (CI 94-99%). For peritoneal fluid, sensitivity, specificity, PPV, and NPV were 77% (CI 46-95%), 81% (CI 69-91%), 50% (CI 27-73%), and 94% (CI 82-99%), respectively. Raising the ADA threshold to 60 U/L improved specificity to 92% in pleural fluid (CI 87-95%) and 85% in peritoneal fluid (CI 73-93%). Combining ADA with other biomarkers showed no added diagnostic value.
conclusionADA testing is a rapid and practical tool for EPTB diagnosis. In pleural and peritoneal fluids, a threshold < 30 U/L effectively excludes EPTB, while a threshold > 60 U/L supports initiating treatment pending culture results.
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