Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: 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)

Sixty-three patients with acute progressive tuberculosis (APPT) underwent splenic ultrasound radiation (SUSR) (Group 1) for evaluation of the efficiency of the procedure. A hundred and twenty five patients with APPT were treated without SUSR (Group 2, controls). An experimental study was also conducted on 290 mice. SUSR was also used in the late first month of antituberculous chemotherapy. A procedure for SUSR is described in the paper. There were most favourable clinical and X-ray changes in Group 1 than in Group 2 just after SUSR and at the end of the treatment course. After the procedure (first control) all biochemical inflammation indices (medium molecular-weight molecules, adenosine deaminase, fibrinogen, sialic acids) were significantly decreased in Group 1. Immunological indices were insignificantly changed between groups and primary investigations. A study after two months of SUSR showed no differences in biochemical indices in the groups and in this period as compared to the control one. At the same time, the levels of CD cells, especially CD8+, were found to be lower in Group 2. In Group 1, the count of CD cells and their functional activity by the blast transforming reaction on PHA were stable and significantly higher than in Group 2. The experimental study demonstrated that the levels of medium molecular-weight molecules and the index of lung damage reduced after SUSR. The decrease in the count of MBT colonies and a positive response in the murine paw test, which is indicative of T-cell immunodeficiency, were detected one month following the procedure (distant control). So SUSR should be proposed as a new effective pathogenetic treatment for APPT.
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PMID:[Effectiveness of the use of ultrasound irradiation of the spleen in patients with acutely progressive pulmonary tuberculosis]. 1222 45

Pleural involvement in brucellosis is very rare. Current knowledge on brucella pleuritis is limited to a few case studies, and pleural adenosine deaminase (ADA) in brucellosis has not been studied previously. We report the pleural fluid characteristics, including ADA, of two cases with brucella pleurisy. Analysis of the pleural fluids revealed exudative effusions with increased ADA level, decreased glucose concentration, and lymphocyte predominance. The similarity with tuberculous pleurisy was remarkable. We suggest that brucellosis should be considered in the differential diagnosis of tuberculosis, especially in regions endemic for both diseases.
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PMID:Increased pleural fluid adenosine deaminase in brucellosis is difficult to differentiate from tuberculosis. 1245 12

Adenosine deaminase (ADA) can aid in the diagnosis of tuberculous pleural effusions, but false-positive findings from lymphocytic effusions have been reported. The purpose of this study is to assess the ADA levels in nontuberculous lymphocytic pleural effusions (lymphocyte count > 50%) of different aetiologies. Altogether, 410 nontuberculous lymphocytic pleural fluid samples were consecutively selected. These included malignant effusions (n = 221), idiopathic effusions (n = 76), parapneumonic effusions (n = 35), postcoronary artery bypass graft surgery effusions (n = 6), miscellaneous exudative effusions (n = 21) and transudative effusions (n = 51). The ADA level reached the diagnostic cut-off for tuberculosis (40 U x L(-1)) in seven of the 410 cases (1.71%). The negative predictive value of ADA for the diagnosis of pleural tuberculosis was 99% (403 of 407 cases) in the group of lymphocytic pleural effusions. In five of these seven patients ADA1 and ADA2 were measured, and in all these cases (100%) ADA1/ADA(p) correctly classified these lymphocytic effusions as nontuberculous (ratio < 0.42). This prospective study provides additional evidence that adenosine deaminase levels in nontuberculous lymphocytic pleural effusions seldom exceed the cut-off set for tuberculous effusions. The pleural fluid adenosine deaminase levels were significantly higher in different types of exudative effusions than in transudates. An adenosine deaminase level < 40 IU x L(-1) virtually excluded a diagnosis of tuberculosis in lymphocytic pleural effusions. Adenosine deaminase1/adenosine deaminase(p) correctly classified all nontuberculous lymphocytic pleural effusions with high adenosine deaminase levels.
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PMID:Diagnostic value of adenosine deaminase in nontuberculous lymphocytic pleural effusions. 1260 33

A 27-year-old male visited the outpatient clinic of our hospital with the chief complaints of fever, right chest pain and shortness of breath. He was admitted to our hospital for detailed examination of the right hydrothorax. The pleural effusion obtained by thoracocentesis was exudative and negative for Mycobacterium tuberculosis. Since the titer of adenosine deaminase in the pleural effusion was abnormally high, antitubercular therapy was started under suspicion of tuberculous pleuritis. Thereafter, the patient's subjective symptoms and blood parameters improved. Necrotic tissues were obtained by pleural biopsy using the Cope needle. In order to make a definitive diagnosis, pleural biopsy was performed thoracoscopically. White tubercular lesions with a smooth surface were sparsely distributed on the pleura. Histopathologically, these lesions were characterized by central areas of caseous necrosis surrounded by epithelial cells and Langhans' giant cells. Therefore, they were considered to be granulomatous lesions. The patient was given a diagnosis of idiopathic tuberculous pleuritis, and was treated with four antitubercular drugs in combination. His clinical signs subsided, and he was discharged. This case indicates that the examination of the inside of the pleural cavity with a flexible bronchoscope, instead of thoracoscope, under local anesthesia is useful to diagnose patients having tuberculous pleuritis.
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PMID:[A case report of tuberculous pleuritis diagnosed by thoracoscopy using fiberoptic bronchoscope]. 1263 61

Tuberculosis is the most frequent cause of death due to infectious diseases. In Europe, it is one of the most frequent types of pleural effusions in young patients. Tuberculosis is caused by the rupture of a pulmonary subpleural caseous focus, which releases mycobacterium into the pleural cavity, thereby triggering an immune response involving mainly macrophages, CD4+ T lymphocytes, and the cytokines released by these cells (especially interleukin 1, interleukin 2, and ?-interferon). In recent years, classical microbiological and histological methods of diagnosis have been joined by biochemical analyses of pleural fluid, which are faster and can be more sensitive. In particular, tuberculous effusions have high adenosine deaminase (ADA) activity, apparently due to high levels of the ADA isoenzyme ADA2, which is only found in monocytes and macrophages (although certain data suggest the possible involvement of activated T cells, too). It has been recommended that treatment for tuberculosis be initiated if analysis of pleural fluid shows high ADA activity, a lymphocyte/neutrophil ratio greater than 0.75, and no malignant cells. Another highly efficient marker is ?-interferon, which is released by activated CD4+ T cells, but its high price is an obstacle to its routine determination in clinical practice. Identification of mycobacterial DNA by means of the polymerase chain reaction (PCR) is less efficient, apparently because its sensitivity depends heavily on mycobacterium concentration. No other biochemical parameters currently appear to be of marked relevance for the diagnosis of tuberculous pleural effusion (TPE). TPE responds well to the standard treatment for tuberculosis. However, 50% of TPE patients have a thickened pleura as a result of the accumulation of fluid, and in 16% the quantity of effusion increases during treatment, even if corticosteroids are administered. It therefore seems reasonable for treatment with antituberculous drugs to be preceded by therapeutic thoracocentesis to remove as much fluid as possible.
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PMID:Tuberculous pleural effusions. 1271 23

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

We report a case of refractory tuberculous meningitis which was markedly improved by intrathecal administration of isoniazid (INH). The patient was a 35-year-old woman diagnosed with systemic lupus erythematosus (SLE) at age 25, who was being managed with steroid therapy. She was admitted to another hospital due to miliary tuberculosis at age 34, and after discharge continued with a regimen of 2 anti-tuberculosis drugs (INH. Rifampicin (RFP)). She was admitted to our hospital with severe headache and fever on June 18, 2001. She showed severe meningeal irritation, and cerebrospinal fluid (CSF) examination revealed cell counts of 207/microliter (72% polynuclear cells), protein level of 300 mg/dl, glucose level of 13 mg/dl, chloride (Cl) level of 104 mEq/l, adenosine deaminase (ADA) level of 10.0 IU/l. The CSF culture was negative for Mycobacterium tuberculosis (M. tuberculosis) and direct polymerase chain reaction (PCR) for M. tuberculosis DNA was negative, but nested PCR was positive in preserved CSF samples. Marked leptomeningeal enhancement at the basilar meninges was noted by cranial MRI on gadolinium (Gd)-DTPA enhanced T1-weighted images. We diagnosed her condition as tuberculous meningitis and administered a total of 5 anti-tuberculosis drugs over about 2 months. However, during this period, both her clinical and CSF findings worsened, and she developed severe consciousness disturbance showing marked hydrocephalus on cranial MRI in August 2001. Therefore, we initiated intrathecal administration of INH 100 mg 3 times a week for progressive tuberculous meningitis. After the initiation of intrathecal therapy, both her consciousness disturbance and CSF findings were improved almost immediately. Ventriculo-peritoneal shunt operation was performed for hydrocephalus on September 26, 2001, and her clinical symptoms were further improved. To our knowledge, this is the first reported case of refractory tuberculous meningitis markedly improved by intrathecal administration of INH. Our findings suggested that intrathecal administration of INH was useful for refractory tuberculous meningitis.
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PMID:[A case of refractory tuberculous meningitis markedly improved by intrathecal administration of isoniazid (INH)]. 1282 May 46

102 patients with verified tuberculosis of the peripheral lymph nodes (TPLN), including 40 patients with specific process in the respiratory apparatus, were examined. The lymph nodes of the neck were found to be primarily affected in such patients (89%); by the 2nd month, conglomerates develop from such nodes, with the latter evolving into fistulas (44.4%) and into abscesses (40%). A high specificity and sensitivity of the test with the blood serum for adenosine deaminase were proven. Different types of anti-tuberculosis antibodies are isolated with various rates; therefore, it is advisable to study the answers to all serological reactions.
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PMID:[Specific features of tuberculosis of peripheral lymph nodes with specific process in the respiratory organs]. 1289 10

Primary peritoneal tuberculosis is a rare presentation of this disease. It is usually associated with ascites and raised CA-125 levels. Occasionally a pelvic mass may be present making the preoperative differential diagnosis from advanced ovarian cancer extremely difficult. Acid-fast stains and special cultures of the ascitic fluid for Mycobacterium tuberculosis are frequently negative, and confirmation of the diagnosis commonly requires histologic examination of biopsy specimens, in which epithelioid granulomas with central caseous necrosis can be identified. We present a case of unexplained pyrexial ascites in a postmenopausal woman in whom the diagnosis of miliary peritoneal tuberculosis was confirmed laparoscopically. The role of noninvasive tools such as measurement of ascitic fluid adenosine deaminase levels is also discussed.
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PMID:Miliary tuberculous peritonitis mimicking advanced ovarian cancer. 1292 Mar 45

A focal reaction plays the leading role in the assessment of segmental tests (ST). The sensitivity of ST is 72.4% and that of the Koch test is 64.5%, their specificity is 94.1 and 80.0%, respectively. A 10% or more increase in adenosine deaminase during peritoneal fluid ST indicates to the exacerbation of genital tuberculosis. Analysis of the cellular composition of peritoneal fluid from the Douglas space is proposed as a criterion for a focal reaction. There are ultrasound symptoms which accompany the exacerbation of an inflammatory process in the genitals in response to ST and which are indicative of a positive focal reaction. The minimum tuberculin load and lack of contraindications allow ST to be introduced into the practical work of tuberculosis facilities.
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PMID:[Comparative analysis of a new modification of segmental tuberculin test with the routine Koch test]. 1452 91


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