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Free Content Diagnostic value of adenosine deaminase in cerebrospinal fluid for tuberculous meningitis: a meta-analysis [Review article]

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OBJECTIVE: To determine the accuracy of adenosine deaminase (ADA) measurements in the diagnosis of tuberculous meningitis (TBM).

DESIGN: After a systematic review of English language studies, the sensitivity, specificity and accuracy of ADA concentrations in the diagnosis of cerebrospinal fluid (CSF) were evaluated using random effects models. Summary receiver operating characteristic curves were used to summarise overall test performance.

RESULTS: Ten studies met our inclusion criteria. The sensitivity of ADA in the diagnosis of TBM was 0.79 (95%CI 0.75–0.83), specificity 0.91 (95%CI 0.89–0.93), positive likelihood ratio 6.85 (95%CI 4.11–11.41), negative likelihood ratio 0.29 (95%CI 0.19–0.44) and diagnostic odds ratio 26.93 (95%CI 12.73–56.97).

CONCLUSION: Our data suggest that ADA in the CSF can be a sensitive and specific target and a critical criteria for the diagnosis of TBM.

Keywords: adenosine deaminase; cerebrospinal fluid; tuberculosis

Document Type: Review Article

Affiliations: 1: Department of Clinical Pharmacy, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China 2: Department of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China

Publication date: 2010-11-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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