Sažetak
Tuberkulozni pleuritis (TP) je jedan od najčešćih ekstrapulmonalnih oblika tuberkuloze. Tuberkulozni pleuritis nastaje kada se Mycobacterium tuberculosis antigen oslobodi iz rupturiranog kazeoznog fokusa u pleuralni prostor i izazove hiperinflamatorni odgovor sa brzim prilivom limfocita.
Direktna mikroskopija za acido-alkoholo rezistentan bacil (AFB), kulture i patohistološki nalaz biopsije kod većine pacijenata su pozitivni samo kod manje od 10% uzoraka. Za dobijanje rezultata kulture potrebno je oko 6-8 nedelja, što odlaže konačnu dijagnozu. Problem nastaje i u diferencijaciji izliva sa limfocitnom predominacijom. Adenozin deaminaza (ADA) je biohemijski marker visoke osetljivosti i specifičnosti i smatra se zlatnim standardom biomarkera u dijagnostici TP. Koristeći algoritam za vrednosti ADA više ili niže od 40 U/L možemo razlikovati ovaj tip izliva od drugih ADA u pleuralnom punktatu.
ADA je brz, efikasan i ekonomičan način za razjašnjavanje etiologije pleuralnog izliva kao što je tuberkulozni pleuritis i odgovora na lečenje u periodu praćenja.
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Reference
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