Diagnostic Accuracy of Lactate Dehydrogenase/Adenosine Deaminase Ratio in Differentiating Tuberculous and Parapneumonic Effusions: A Systematic review

Larry Ellee Nyanti, M.R.C.P.I. and Muhammad Aklil Abd Rahim, Dr.P.H and Nai-Chien Huan, M.R.C.P (2023) Diagnostic Accuracy of Lactate Dehydrogenase/Adenosine Deaminase Ratio in Differentiating Tuberculous and Parapneumonic Effusions: A Systematic review. tuberculosis & respiratory diseases. pp. 1-9. ISSN 1738-3536

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URL: https://pubmed.ncbi.nlm.nih.gov/37726943/#:~:text=...

Abstract

Background: Tuberculous pleural effusion (TPE) and parapneumonic effusion (PPE) are often difficult to differentiate owing to the overlapping clinical features. Observational studies demonstrate that the ratio of lactate dehydrogenase to adenosine deaminase (LDH/ADA) is lower in TPE compared to PPE, but integrated analysis is warranted. Methods: We conducted a systematic review to evaluate the diagnostic accuracy of the LDH/ADA ratio in differentiating TPE and PPE. We explored the PubMed and Scopus databases for studies evaluating the LDH/ADA ratio in differentiating TPE and PPE. Results: From a yield of 110 studies, five were included for systematic review. The cutoff value for the LDH/ADA ratio in TPE ranged from <14.2 to <25. The studies demonstrated high heterogeneity, precluding meta-analysis. Quality Assessment of Diagnostic Accuracy Studies Tool 2 assessment revealed a high risk of bias in terms of patient selection and index test. Conclusion: LDH/ADA ratio is a potentially useful parameter to differentiate between TPE and PPE. Based on the limited data, we recommend an LDH/ADA ratio cutoff value of <15 in differentiating TPE and PPE. However, more rigorous studies are needed to further validate this recommendation.

Item Type:	Article
Keyword:	Lactate Dehydrogenase; Adenosine Deaminase; Tuberculous Pleural Effusion; Parapneumonic Effusion; Diagnostic Accuracy
Subjects:	R Medicine > RC Internal medicine > RC31-1245 Internal medicine R Medicine > RC Internal medicine > RC31-1245 Internal medicine > RC581-951 Specialties of internal medicine
Department:	FACULTY > Faculty of Medicine and Health Sciences
Depositing User:	ABDULLAH BIN SABUDIN -
Date Deposited:	05 Feb 2024 15:27
Last Modified:	05 Feb 2024 15:27
URI:	https://eprints.ums.edu.my/id/eprint/38137

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