Factors associated with negative pleural adenosine deaminase results in the diagnosis of childhood pleural tuberculosis

BMC Infectious Diseases

Chao Han¹  Mao-Shui Wang²  Jun-Li Wang³  Feng Jin⁴  Xing-Fen Han⁵ 

[1] Department of Geriatrics, Shandong Mental Health Center, Jinan, China;Department of Lab Medicine, Shandong Provincial Chest Hospital, Cheeloo College of Medicine, Shandong University, 46# Lishan Road, 250013, Jinan city, Shandong, P. R. China;Department of Lab Medicine, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China;Department of Thoracic Surgery, Shandong Provincial Chest Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China;Department of Tuberculosis, Shandong Provincial Chest Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China;

关键词: Childhood pleural tuberculosis;    Adenosine deaminase;    Risk factor;    Pleural effusion;    Diagnosis;   

DOI  :  10.1186/s12879-021-06209-1

来源: Springer

【 摘 要 】

BackgroundUntil now, the influential factors associated with pleural adenosine deaminase (ADA) activity among children remain unclear. This retrospective study was therefore conducted aiming to investigate the factors associated with negative pleural ADA results in the diagnosis of childhood pleural tuberculosis (TB).MethodsBetween January 2006 and December 2019, children patients with definite or possible pleural TB were recruited for potential analysis. Then, patients were stratified into two categories: negative pleural ADA results group (experimental group, ≤40 U/L) and positive pleural ADA results group (control group, > 40 U/L). Univariate and multivariate logistic regression analyses were performed to estimate risk factors for negative pleural ADA results.ResultsA total of 84 patients with pleural TB were recruited and subsequently classified as experimental (n = 17) and control groups (n = 67). Multivariate analysis (Hosmer–Lemeshow goodness-of-fit test: χ2 = 1.881, df = 6, P = 0.930) revealed that variables, such as chest pain (age-adjusted OR = 0.0510, 95% CI: 0.004, 0.583), pleural total protein (≤45.3 g/L, age-adjusted OR = 27.7, 95% CI: 2.5, 307.7), pleural lactate dehydrogenase (LDH, ≤505 U/L, age-adjusted OR = 59.9, 95% CI: 4.2, 857.2) and blood urea nitrogen (≤3.2 mmol/L, age-adjusted OR = 32.0, 95% CI: 2.4, 426.9), were associated with negative pleural ADA results when diagnosing childhood pleural TB.ConclusionOur findings demonstrated that chest pain, pleural total protein, pleural LDH, and blood urea nitrogen were associated with a negative pleural ADA result for the diagnosis of pleural TB among children. When interpreting pleural ADA levels in children with these characteristics, a careful clinical assessment is required for the pleural TB diagnosis.

【 授权许可】

CC BY