Diagnostic Significance of Pleural Fluid ADA and Hematological Parameters in Pediatric Tubercular Versus Non-Tubercular Pleural Effusion
Nabila Islam
Registrar Department of Paediatrics Dhaka Central International Medical College & Hospital Dhaka, Bangladesh Email: nabilaislam204@gmail.com
Farhat Lamisa Kabir
Registrar Department of PICU Bangladesh Shishu Hospital and Institute Dhaka, Bangladesh
Md. Asif Mahmud
Consultant Department of CCU Pro Active Hospital Dhaka, Bangladesh
Keywords: Pleural fluid, ADA, Pediatric tuberculosis, Pleural effusion
Abstract
Background:
Pediatric pleural effusions arise from diverse etiologies, with
tuberculous pleural effusion (TPE) and non-tuberculous causes being the
most common. Early differentiation is essential for timely management.
Objective:
This study aimed to evaluate the diagnostic significance of pleural fluid
ADA and hematological parameters in distinguishing pediatric
tubercular versus non-tubercular pleural effusions.
Methods:
A cross-sectional study was conducted at Bangladesh Shishu Hospital
and Institute from July 2019 to January 2022, including 47 children aged
1-18 years with pleural effusion. The diagnostic performance of pleural
fluid ADA and key hematological parameters was analyzed using SPSS
26.
Results:
Pleural ADA was markedly higher in TPE than in non-TPE cases
(90.6±52.0 vs. 36.0±11.5 U/L). TPE patients showed significantly lower
total WBC counts and polymorph percentages, but higher lymphocyte
percentages and ESR (P<0.05). Hemoglobin, platelet count, and CRP
showed no significant group differences.
Conclusion:
Pleural fluid ADA, combined with selected haematological parameters,
provides meaningful discrimination between tubercular and
non-tubercular pediatric pleural effusions and supports clinical
decision-making
J Rang Med Col. March 2026; Vol.11, No.1:172-176