Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.5.4.4 (adenosine deaminase)
 5,136 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We present a case of tuberculous pericarditis that was diagnosed early by a high titer of adenosine deaminase activity in the pericardial fluid and by a strongly positive tuberculin test. Within 2 weeks of initiation of treatment, pericardial effusion gradually decreased while clinical symptoms improved markedly. Culture from sputum, gastric juice, urine, and pericardial fluid were negative for tubercle bacillus. Measurement of adenosine deaminase activity in the pericardial fluid is a supplementary diagnostic test which is as important as for tuberculous pericarditis as it is for tuberculous pleuritis, because negative Ziehl Neelsen staining and culture for tubercle bacillus are common in tuberculous pericarditis.
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PMID:Tuberculous pericarditis: importance of adenosine deaminase activity in pericardial fluid. 831 71

An 81-year-old man was admitted to our hospital because of pericardial effusion and sputum PCR positive for Mycobacterium (M.) tuberculosis. Since adenosine deaminase (ADA) value of the pericardial effusion was not high and the sputum smear and culture were negative, anti-tuberculous therapy was not started. Two months later he was admitted again because of high fever and cardiomegaly. Chest computed tomography showed deterioration and the sputum culture revealed M. tuberculosis. The ADA value of the pericardial effusion which was not high at the first admission, was elevated in the second admission, and the diagnosis was made as tuberculous pericarditis two months later. We had better start anti-tuberculous therapy at the first admission, in spite of low value of ADA, as his pericardial effusion showed lymphocyte predominance.
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PMID:[A case of tuberculous pericarditis, the diagnosis of which was complicated by the delay in the rise of adenosine deaminase in the pericardial effusion]. 1280 84

A 72-year-old woman was admitted with chest discomfort and general fatigue. She was diagnosed as having cardiac tamponade with massive pericardial effusion. Percutaneous pericardiocentesis yielded bloody effusion. Tuberculous pericarditis was suspected owing to the adenosine deaminase level in this fluid. Video-assisted thoracoscopic pericardial fenestration (VATSPF) was performed for the diagnosis and treatment. Polymerase chain reaction detected Mycobacterium tuberculosis DNA in the pericardial tissues, confirming the diagnosis of tuberculous pericarditis. She received a combination of three-kind medication and anti-tuberculous regimen, and a follow-up check up for more than 2 years, exhibiting a good postoperative course. We conclude that VATSPF can be a useful procedure not only for diagnosis but for release of tuberculous pericarditis with cardiac tamponade and for prophylaxis of constrictive pericarditis.
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PMID:Video-assisted thoracoscopic pericardial fenestration for tuberculous pericardial effusion. 1499 74

A 61-year-old man was admitted to our hospital with cough, breathlessness, anorexia and chest pain. Chest radiograph showed right pleural effusion and also a chest CT scan showed right pleural effusion with thickening of the right visceral pleura, pericardial effusion and a liver tumor. The pleural effusion was slightly bloody and exudative. The adenosine deaminase (ADA) level in the pleural effusion was elevated. Because the cytological examintion of the pleural effusion showed no malignancy, we diagnosed pleuritis tuberculosa. The serum-soluble interleukin-2 receptor level was also elevated. His general condition worsened in spite of the chemotherapy with antibiotics and antituberculous drugs. We finally diagnosed the case as natural killer (NK) cell lymphoma from CT-guided needle biopsy just before death, and necropsy. In this case, the high level of ADA in the pleural effusion suggested lymphoma.
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PMID:[A case of natural killer cell lymphoma with high adenosine deaminase level in pleural effusion]. 1599 86

Prospectively, clinical and biochemical data of 83 patients with a diagnosis of pericardial effusion were studied. The etiologies were as follows: Idiopathic: 42 cases (50%); Tuberculous: 18 cases (22%); Neoplastic: 14 cases (17%); Other: 9 cases (11%) with a miscellaneous etiology. Sedimentation rate resulted significantly higher in Tuberculous group (67-102), p<0.05. The highest values of adenosine deaminase in pericardial fluid were observed in Tuberculous group (110 U/l), p<0.001. Diagnosis of tuberculosis was established by culture of the bacillus in sputum in 8 cases and by pericardial biopsy in 11 patients. Analysis of the pericardial fluid leads to diagnosis in 25 cases (30%). The pericardial biopsy resulted as the most reliable method for the diagnosis of tuberculous pericarditis.
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PMID:Pericardial effusion: clinical and analytical parameters clues. 1652 Jan 29

Not long ago, primary tuberculosis was considered a rare disease; now with an increasing incidence worldwide, physicians should relearn many of its basic aspects and manifestations. Pericarditis is a rare finding seen with tuberculosis, but its prognosis is excellent with treatment, so early diagnosis is crucial. Pathogenesis is particularly important, and it must be taken in consideration when interpreting diagnostic tools. Herein we report on a healthy 32-year-old woman who presents with a 1-month history of febrile illness, malaise, and weakness; more recently, she also had resting dyspnea, which was progressively worsening. A positive PPD and an abnormal chest radiograph prompted hospitalization, where she was found to have pulsus paradoxus of 20 mm Hg. The echocardiogram showed diastolic right chamber collapse along with respiratory variation of the mitral inflow, consistent with pericardial tamponade. A pericardiocentesis was performed with resolution of her resting dyspnea; more than 1000 mL of serous fluid drained from the pericardial space over the following 24 hours. Although sputum and pericardial fluid cultures and smear for AFB and other organisms were negative, as well as a negative pericardial fluid PCR for Mycobacterium tuberculosis DNA; an elevated (44.4 U/L [normal, 0 to 18]) adenosine deaminase level in the pericardial fluid was consistent with the probable diagnosis of tuberculous pericardial effusion. The patient was treated with resolution of the clinical syndrome and no recurrence of the effusion thereafter. Adenosine deaminase, an enzyme marker of cell-mediated immune response activity to M tuberculosis that includes activated T-lymphocytes and macrophages, appears in pericardial fluid. The diagnosis of probable tuberculous effusion can be made without demonstration of mycobacterium.
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PMID:Adenosine deaminase in the diagnosis of tuberculous pericardial effusion. 1879 13

A 71-year-old woman was admitted with a diagnosis of cardiac tamponade. Emergency transthoracic echocardiography showed a large amount of pericardial effusion compressing the whole heart. Pericardiocentesis was performed immediately and nearly 1 liter of hemorrhagic fluid was aspirated. Pathological result of the pericardiocentesis material was benign, acid-resistant bacteria were not found in the pericardial fluid, and bacteria cultures were negative. The only parameter suggesting tuberculous pericarditis was adenosine deaminase activity in the pericardial fluid, which was measured as 76 U/l. With antituberculosis therapy for six months, the patient showed complete improvement; no signs of deterioration were observed and echocardiographic findings were normal.
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PMID:A case of cardiac tamponade caused by tuberculous pericarditis. 1915 66

Disorders of the pericardium are commonly associated with pericardial effusion. Its etiology comprises a broad spectrum of diseases including also malignancies. Pericardiocentesis, pericardioscopy and targeted epicardial biopsy with consecutive pericardial fluid and epicardial biopsy analysis by cytology, molecular biology and immunology establish the underlying etiology in the majority of cases. Of particular therapeutic and prognostic importance is the definite differentiation of malignant pericardial effusion from benign pericardial effusion. Biomarkers for cardiovascular diseases can be divided into biochemical, histological, immunologic, serologic and molecular markers as well as imaging biomarkers. Biomarkers have proven to be useful in the diagnosis, differential diagnosis and prognosis of ischemic heart disease and heart failure. With respect to pericardial disorders, a comprehensive approach combining clinical information, imaging biomarkers, biomarkers of pericardial effusion and analysis of epicardial biopsies often leads to the definite etiologic diagnosis of pericardial effusion. Computed tomography and magnetic resonance imaging allow further characterization of the effusion and, of note, also of the surrounding tissue, which is of particular interest in case of malignancies. Biomarkers of pericardial effusion include biochemical markers, autoantibodies, tumor markers, and cytokines. Analysis of pericardial fluid specific gravity, protein level and lactate dehydrogenase (LDH) separates transudates from exsudates. High adenosine deaminase levels (ADA) and low levels of carcinoembryonic antigen (CEA) in the pericardial effusion are observed in tuberculous pericarditis allowing the differentiation from malignant pericardial effusion. Additional markers, such as interferon and lysozyme, have also been suggested for the diagnosis of tuberculous pericarditis. Tumor markers in pericardial fluid have been used to diagnose malignant pericarditis. CEA levels are significantly higher in malignant than benign effusion. By a cutoff level of CEA > 5 ng/ml the diagnostic sensitivity and specificity are 75% and 100%, respectively, in the diagnosis of malignant pericardial effusion. Further analysis of cytokines and mediators, serologic, immunologic and inflammatory markers may help to understand the pathophysiology of the pericardial disease and provide useful diagnostic information.
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PMID:[Differentiation of malignant from nonmalignant, inflammatory pericardial effusions with biomarkers]. 2002 42

Pericardial effusion might be the first presentation of various pathologies including malignant tumors. Massive pericardial effusion as the primary manifestation of high-grade malignant lymphoma is a very rare condition. A 53-year-old woman presented with progressive dyspnea of one-week history. Physical examination showed venous distention of the neck veins and diminished heart sounds. The chest X-ray demonstrated increased cardiothoracic index. Transthoracic and transesophageal echocardiographic examinations showed massive pericardial effusion without any other pathology. Hematologic and biochemical tests showed only anemia. The patient underwent pericardiocentesis. Pericardial adenosine deaminase test and cultures were negative. Cytopathologic examination of the fluid showed huge lymphocytes and highly atypical lymphoid cells consistent with high-grade malignant lymphoma (non-Hodgkin's lymphoma). Immunohistochemical analysis showed positivity for leukocyte common antigen. No other primary origin could be determined.
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PMID:Massive pericardial effusion as the primary manifestation of high-grade malignant lymphoma. 2020 Apr 63

An 86-year-old male was admitted to Izumikawa Hospital complaining of fever and chest pain. Electrocardiography revealed low-voltage, atrial fibrillation and QRS complexes. The chest PA-view showed an increased cardiothoracic ratio (65.9%) and an infiltrative shadow in the left lower lung field. Computed tomography revealed copious pericardial and bilateral pleural effusion. Pericardiocentesis was performed immediately after admission, and 80 ml of hemorrhagic fluid was aspirated. The adenosine deaminase activity of the pericardial fluid was 77.2 IU/l, and testing for tuberculous bacilli by polymerase chain reaction was positive. As these parameters strongly suggested tuberculous pericarditis, pericardial drainage was continued for another two weeks, and a delayed combination therapy with isoniazid, rifampicin, streptomycin, and a high dose of prednisolone was initiated. Two weeks later, the symptoms were relieved and the pericardial effusion had also decreased.
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PMID:[A case of cardiac tamponade caused by tuberculous pericarditis]. 2038 9


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