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Serum adenosine deaminase levels in diagnosis of acute appendicitis
  1. Z A Öztürk1,
  2. S Köklü2,
  3. M F Erol3,
  4. F M Yılmaz4,
  5. Ö Başar5,
  6. O Yüksel6,
  7. G Yılmaz4,
  8. B Kısacık7,
  9. İ Yüksel5
  1. 1
    Department of Internal Medicine, Ankara Education and Research Hospital, Ankara, Turkey
  2. 2
    Department of Gastroenterology, Ankara Education and Research Hospital, Ankara, Turkey
  3. 3
    Department of Surgery, Ankara Education and Research Hospital, Ankara, Turkey
  4. 4
    Department of Biochemistry, Ankara Education and Research Hospital, Ankara, Turkey
  5. 5
    Department of Gastroenterology, Ankara Dışkapı Education and Research Hospital, Ankara, Turkey
  6. 6
    Department of Gastroenterology, Ankara Numune Hospital, Ankara, Turkey
  7. 7
    Department of Rheumatology, Hacettepe University School of Medicine, Ankara, Turkey
  1. Dr S Köklü, Karargahtepe mahallesi, Kumrulu sokak, 18/1 Keçiören, Ankara, Turkey; gskoklu{at}


Background: Adenosine deaminase (ADA) is found in most tissues including lymphoid cells and lymph nodes. It is a marker of T lymphocyte activation. The role of type 1 and type 2 T helper cells in appendicitis has been investigated experimentally. Serum ADA levels in acute appendicitis have not previously been studied.

Aim: To assess the serum levels of ADA in patients with acute appendicitis.

Methods: Serum levels of ADA were investigated in 30 cases with acute appendicitis (mean age 26 years; male/female 17/13) and 21 healthy controls (mean age 40 years; male/female 11/10). Levels of ADA were compared in patients with acute appendicitis and healthy controls. Correlation analysis between ADA and other inflammatory markers (C-reactive protein (CRP), high-sensitivity CRP, erythrocyte sedimentation rate and white blood cell count) was also performed.

Results: Mean (SD) serum ADA levels were significantly higher in those with acute appendicitis than in the control group (13.41 (3.56) U/l vs 9.39 (1.22) U/l; p<0.001). There was no correlation between ADA and the other inflammatory markers investigated.

Conclusions: Although serum levels of ADA do not correlate with other known inflammatory markers, its serum level is increased in acute appendicitis and it has a higher positive predictive value.

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  • Competing interests: None.

  • Ethics approval: Ethics approval was obtained from the Ankara Training and Research Hospital for this study.