*1Hassan Aboud Kareem *2 Ahmed Asmer Mankhi *1 Hind Hussien Obaid.
1. college of science-Department of biology /University of Baghdad.
2. Ministry of Health / Specialized Center of Chest Respiratory Disease.
Background: Definitive laboratory diagnosis and confirmation of sputum negative pulmonary tuberculosis (SNPTB) poses a major challenge in the management and control of active pulmonary tuberculosis (PTB) in clinical practice.
Objectives: The objective to assess the levels of adenosine deaminase (ADA) in serum of patients SNPTB and to compare it with serum ADA levels in healthy control group and to explore its validity as a diagnostic marker in serum of SNPTB.
Study design: The prospective study done in Ministry of Health / Specialized Center of Chest Respiratory Disease in Baghdad. A total of 110 specimens collected in this center, that include 85 specimens for patients and 25 for control healthy.
Methodology: Fifty-four male and thirty-one female patients presenting with PTB were included in the study. Zeihl-Neelsen stain examination for direct smear microscopy and Lowenstein Jensen medium were prepared according to guidelines of laboratory manual work (2009). Serum samples were collected and ADA assay was done by the method of Guisti.
Results: All specimens that used in our study refer to results of ZN test, 50(58.82%) positive results by this test other than 35(40.18%) negative result with sensitivity (58.8%), but showed distribution results of culture LJ medium in category patients, 81(95.3%) positive results by this test other than 4(4.7%) negative results. The positive results by ADA test showed 83 (97.6%). The Mean ± S.E of ADA in PTB was 34.96±3.11 U/L while it was10.64 ± 0.36 U/L in non-PTB patients.
Conclusion: As a conclusion serum ADA level may be proposed as a proper index for TB diagnosis, the sensitivity for this test was (97.6%), therefore, serum ADA could be also used for diagnosis of PTB. Hence, for facilitate diagnosis TB. .There is an increased level of enzyme ADA in SNPTB of patients as compared to smear positive PTB and healthy control.