Evidence map›Paper›PMID 40779008›Full record

ArticleInfection2025

Diagnostic performance of adenosine deaminase for extrapulmonary tuberculosis in a higher-prevalence area of mainland France: a 10-year retrospective study.

Quiterie Boscals de Réals, Ugo Françoise, Nicolas Vignier, Hervé Delacour, Frédéric Méchaï

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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.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Quiterie Boscals de RéalsDepartment of Infectious and Tropical diseases, Hôpitaux universitaires Paris Seine-Saint-Denis, Avicenne & Jean Verdier Hospitals, AP-HP, Bobigny, France. quiterie.dereals@gmail.com.ORCID http://orcid.org/0009-0008-3263-9462
Ugo FrançoiseCentre d'investigation clinique Antilles-Guyane (CIC INSERM 1424), Centre hospitalier de Cayenne, Cayenne, Guyane Française, France.ORCID http://orcid.org/0000-0002-3239-5145
Nicolas VignierDepartment of Infectious and Tropical diseases, Hôpitaux universitaires Paris Seine-Saint-Denis, Avicenne & Jean Verdier Hospitals, AP-HP, Bobigny, France.ORCID http://orcid.org/0000-0002-9410-9327
Hervé DelacourDépartement de biologie, Hôpital National d'Instruction des Armées BEGIN, 69, avenue de Paris, Saint Mandé, 94 160, France.ORCID http://orcid.org/0000-0002-1150-0209
Frédéric MéchaïDepartment of Infectious and Tropical diseases, Hôpitaux universitaires Paris Seine-Saint-Denis, Avicenne & Jean Verdier Hospitals, AP-HP, Bobigny, France.ORCID http://orcid.org/0000-0003-1867-1163

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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.

Indexed as

Adenosine DeaminaseTuberculosisAdolescentAdultAgedAged, 80 and overFemaleFranceHumansMaleMiddle AgedPrevalenceRetrospective StudiesSensitivity and SpecificityTuberculosis, ExtrapulmonaryYoung AdultAdenosine DeaminaseAdenosine deaminase (ADA)Diagnostic performanceExtrapulmonary tuberculosis (EPTB)

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.