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DIAGNOSTIC VALUES OF INTERLEUKINS 27, 35 AND ADA FOR TUBERCULOSIS PLEURAL EFFUSION: A REVIEW STUDY

Dr Saqib Jamal, Dr Zeeshan Ahmed Solangi

Aim of review: This review sum up the current data regarding the accuracy of pleural fluid tests (ADA, IL27 and IL 35) in making the diagnosis of tuberculosis pleural effusion. Recent findings: No pleural fluid test reliably rules-in TPE in settings with low TPE prevalence. ADA can reliably rule-out TPE in prevalences of less than 40% although in higher prevalences the product of interleukin-27 and ADA is the most accurate rule-out test. Summary: The definite diagnosis of TPE requires the isolation of Mycobacterium tuberculosis from pleural fluid or biopsies. The concept of a pleural fluid test that accurately due to the low sensitivity of pleural fluid cultures and the invasiveness of pleural biopsy techniques .Many pleural fluid diagnostic tests have been evaluated and the most widely accepted one test for this purpose is ADA. During the last years, it has been demonstrated that the ability of ADA to rule-in or rule-out TPE is affected by the prevalence of TPE in the setting where the test is used. The complementary use of interferon-g or interleukin-27 increases the ability of ADA to rule-in or rule-out the disease, respectively. Keywords adenosine deaminase, IL-35, interleukin-27, tuberculosis pleural effusion

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