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Pericardial fluid adenosine deaminase in the diagnosis of tuberculous pericardial effusion

Report by: Kai Kit Tsim, Medical Student

Search checked by: Giles N Cattermole, Assistant Professor

Institution: Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, People's Republic of China

Three-part question

In [patients with tuberculous pericardial effusion] is [adenosine deaminase (ADA)] useful in [the diagnosis of tuberculosis (TB)]?

Clinical scenario

A 65-year-old male, with past medical history of pulmonary TB, attends the Emergency Department with shortness of breath and central chest pain for 7 days. Physical examination reveals raised JVP and chest x-ray shows a globular-shaped heart. You wonder whether pericardial fluid ADA level would assist in the diagnosis of tuberculous pericardial effusion.

Search strategy

Medline, 1950–October 2009, using the Ovid interface.

(exp Adenosine Deaminase/OR (adenosine deaminase or ADA).mp) AND (exp Tuberculosis, Cardiovascular/ OR ((exp Tuberculosis/ OR (TB or tubercul$).mp) AND (exp Pericarditis/OR pericardi$.mp))) LIMIT to human and English language.

Search outcome

Thirty-four papers were …

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  • Competing interests None.

  • Provenance and peer review Not Commissioned; not externally peer reviewed.