Research Article

Utility of Ascitic Fluid Adenosine Deaminase Levels in the Diagnosis of Tuberculous Peritonitis in General Medical Practice

Table 1

Characteristics, causes, and consequences of patients with high ascitic ADA levels (≥40 IU/L).

Ascitic fluid examinationDiagnosisOutcome
AFB smearAFB cultureTb PCRCell count (differential)SAAG < 1.1Cytology (class)ADA (IU/L)

Tuberculosis
1(−)(−)(−)1,090/μL (N 24%, L 69%)NoII44.0PeritonitisHistopathology of the peritoneal specimenLost to follow-up
2(−)(−)(−)130/μL (L 99%)YesII76.1Peritonitis, pleuritisCulture for Tb of the pleural effusionImproved
3(−)(+)(−)700/μL (N 1%, L 96%)YesI87.4PeritonitisCulture for Tb of ascitic fluidCured
4(−)(−)(−)740/μL (N 2%, L 90%)YesU102.2DisseminatedHistopathology of the testis and culture and PCR for Tb of the urineCured
5(−)(−)NT1,640/μL (N 12%, L 56%)YesI138.2Peritonitis, pleuritisPeritoneal nodules and PCR for Tb of the sputumImproved
6(−)(−)NT46,400/μL (N 96%, L 3%)NTI176.1PeritonitisClinical courseCured
7(−)(−)(−)290/μL (N 51%, L 40%)NTNT57.3Peritonitis, pulmonary TbCulture and PCR for Tb of the peritoneal specimen and sputumDied
8(−)(+)(−)190/μL (N 10%, L 83%)NTI64.9Peritonitis, pleuritisCulture and PCR for Tb of the pleural effusion, urine, and sputumImproved

Lymphoma
9NTNTNT7,000/μL (N 3%, A 97%)NTV50.0NK/T-cell lymphomaCytology of the ascitic fluidDied
10(−)(−)(−)12,400/μL (N 8%, L 9%, A 83%)YesV71.6B-cell lymphomaCytology of the ascitic fluidDied
11(−)(−)(−)570/μL (N 29%, L 22%, A 41%)YesV157.9NK/T-cell lymphomaCytology of the ascitic fluid and histopathology of the skin and lymph node specimensDied
12NTNTNT8,500/μL (N 14%, L 9%, A 73%)NTV45.5T-cell lymphomaCytology of the ascitic fluid and histopathology of the lymph node specimensDied

Others
13NTNTNT5,790/μL (N 79%, L 2%, A 1%)NTIV97.2CP, BPCytology and bacterial culture of the ascitic fluid and histopathology of the liver specimenDied
14NTNTNT84,250/μL (N 81%, L 9%)NTV153.0CP, BPCytology and bacterial culture of the ascitic fluidDied
15(−)(−)(−)112,000/μL (N 54%, L 22%)NTI87.2PIDNucleic acid amplification test for Chlamydia trachomatis of the endocervical specimenCured

AFB, acid-fast bacilli; Tb, tuberculosis; PCR, polymerase chain reaction; SAAG, serum-to-ascites albumin gradient; ADA, adenosine deaminase; NT, not tested; N, neutrophils; L, lymphocytes; A, atypical cell; U, unclassifiable; NK, natural killer; CP, carcinomatous peritonitis; BP, bacterial peritonitis; PID, pelvic inflammatory disease.