Diagnostic Accuracy of Lactate Dehydrogenase/Adenosine Deaminase Ratio in Differentiating Tuberculous and Parapneumonic Effusions: A Systematic review
Background: Tuberculous pleural effusion (TPE) and parapneumonic effusion (PPE) are often difficult to differentiate owing to the overlapping clinical features. Observational studies demonstrate that the ratio of lactate dehydrogenase to adenosine deaminase (LDH/ADA) is lower in TPE compared to PPE,...
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| Format: | Article |
| Language: | English English |
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National Library of Medicine
2023
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| Online Access: | https://eprints.ums.edu.my/id/eprint/38137/1/ABSTRACT.pdf https://eprints.ums.edu.my/id/eprint/38137/2/FULL%20TEXT.pdf |
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| author | Larry Ellee Nyanti, M.R.C.P.I. Muhammad Aklil Abd Rahim, Dr.P.H Nai-Chien Huan, M.R.C.P |
| author_facet | Larry Ellee Nyanti, M.R.C.P.I. Muhammad Aklil Abd Rahim, Dr.P.H Nai-Chien Huan, M.R.C.P |
| author_sort | Larry Ellee Nyanti, M.R.C.P.I. |
| collection | UMS |
| description | Background: Tuberculous pleural effusion (TPE) and parapneumonic effusion (PPE) are often difficult to differentiate owing to the overlapping clinical features. Observational studies demonstrate that the ratio of lactate dehydrogenase to adenosine deaminase (LDH/ADA) is lower in TPE compared to PPE, but integrated analysis is warranted. Methods: We conducted a systematic review to evaluate the diagnostic accuracy of the LDH/ADA ratio in differentiating TPE and PPE. We explored the PubMed and Scopus databases for studies evaluating the LDH/ADA ratio in differentiating TPE and PPE. Results: From a yield of 110 studies, five were included for systematic review. The cutoff value for the LDH/ADA ratio in TPE ranged from <14.2 to <25. The studies demonstrated high heterogeneity, precluding meta-analysis. Quality Assessment of Diagnostic Accuracy Studies Tool 2 assessment revealed a high risk of bias in terms of patient selection and index test. Conclusion: LDH/ADA ratio is a potentially useful parameter to differentiate between TPE and PPE. Based on the limited data, we recommend an LDH/ADA ratio cutoff value of <15 in differentiating TPE and PPE. However, more rigorous studies are needed to further validate this recommendation. |
| first_indexed | 2024-03-06T03:27:29Z |
| format | Article |
| id | ums.eprints-38137 |
| institution | Universiti Malaysia Sabah |
| language | English English |
| last_indexed | 2024-03-06T03:27:29Z |
| publishDate | 2023 |
| publisher | National Library of Medicine |
| record_format | dspace |
| spelling | ums.eprints-381372024-02-05T07:27:38Z https://eprints.ums.edu.my/id/eprint/38137/ Diagnostic Accuracy of Lactate Dehydrogenase/Adenosine Deaminase Ratio in Differentiating Tuberculous and Parapneumonic Effusions: A Systematic review Larry Ellee Nyanti, M.R.C.P.I. Muhammad Aklil Abd Rahim, Dr.P.H Nai-Chien Huan, M.R.C.P RC31-1245 Internal medicine RC581-951 Specialties of internal medicine Background: Tuberculous pleural effusion (TPE) and parapneumonic effusion (PPE) are often difficult to differentiate owing to the overlapping clinical features. Observational studies demonstrate that the ratio of lactate dehydrogenase to adenosine deaminase (LDH/ADA) is lower in TPE compared to PPE, but integrated analysis is warranted. Methods: We conducted a systematic review to evaluate the diagnostic accuracy of the LDH/ADA ratio in differentiating TPE and PPE. We explored the PubMed and Scopus databases for studies evaluating the LDH/ADA ratio in differentiating TPE and PPE. Results: From a yield of 110 studies, five were included for systematic review. The cutoff value for the LDH/ADA ratio in TPE ranged from <14.2 to <25. The studies demonstrated high heterogeneity, precluding meta-analysis. Quality Assessment of Diagnostic Accuracy Studies Tool 2 assessment revealed a high risk of bias in terms of patient selection and index test. Conclusion: LDH/ADA ratio is a potentially useful parameter to differentiate between TPE and PPE. Based on the limited data, we recommend an LDH/ADA ratio cutoff value of <15 in differentiating TPE and PPE. However, more rigorous studies are needed to further validate this recommendation. National Library of Medicine 2023 Article NonPeerReviewed text en https://eprints.ums.edu.my/id/eprint/38137/1/ABSTRACT.pdf text en https://eprints.ums.edu.my/id/eprint/38137/2/FULL%20TEXT.pdf Larry Ellee Nyanti, M.R.C.P.I. and Muhammad Aklil Abd Rahim, Dr.P.H and Nai-Chien Huan, M.R.C.P (2023) Diagnostic Accuracy of Lactate Dehydrogenase/Adenosine Deaminase Ratio in Differentiating Tuberculous and Parapneumonic Effusions: A Systematic review. tuberculosis & respiratory diseases. pp. 1-9. ISSN 1738-3536 https://doi.org/10.4046/trd.2023.0107 |
| spellingShingle | RC31-1245 Internal medicine RC581-951 Specialties of internal medicine Larry Ellee Nyanti, M.R.C.P.I. Muhammad Aklil Abd Rahim, Dr.P.H Nai-Chien Huan, M.R.C.P Diagnostic Accuracy of Lactate Dehydrogenase/Adenosine Deaminase Ratio in Differentiating Tuberculous and Parapneumonic Effusions: A Systematic review |
| title | Diagnostic Accuracy of Lactate Dehydrogenase/Adenosine Deaminase Ratio in Differentiating Tuberculous and Parapneumonic Effusions: A Systematic review |
| title_full | Diagnostic Accuracy of Lactate Dehydrogenase/Adenosine Deaminase Ratio in Differentiating Tuberculous and Parapneumonic Effusions: A Systematic review |
| title_fullStr | Diagnostic Accuracy of Lactate Dehydrogenase/Adenosine Deaminase Ratio in Differentiating Tuberculous and Parapneumonic Effusions: A Systematic review |
| title_full_unstemmed | Diagnostic Accuracy of Lactate Dehydrogenase/Adenosine Deaminase Ratio in Differentiating Tuberculous and Parapneumonic Effusions: A Systematic review |
| title_short | Diagnostic Accuracy of Lactate Dehydrogenase/Adenosine Deaminase Ratio in Differentiating Tuberculous and Parapneumonic Effusions: A Systematic review |
| title_sort | diagnostic accuracy of lactate dehydrogenase adenosine deaminase ratio in differentiating tuberculous and parapneumonic effusions a systematic review |
| topic | RC31-1245 Internal medicine RC581-951 Specialties of internal medicine |
| url | https://eprints.ums.edu.my/id/eprint/38137/1/ABSTRACT.pdf https://eprints.ums.edu.my/id/eprint/38137/2/FULL%20TEXT.pdf |
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