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Adenosine Deaminase, CSF

Item Value
Approval req'd? No
Available Stat? No
Utilization Guidelines Given the relatively low prevalence of tuberculosis ADA should be ordered only in patients with a moderate to high index of suspicion for tuberculosis (Positive personal, family or TB exposure history, positive PPD, etc.) with an exudative effusion containing high numbers of lymphocytes that is negative for mycobacteria by direct examination and culture.
Test code ADAC
Test group Adenosine deaminase
Performed by Quest
Sendout? Yes
Method Kinetic Spectrophotometric
Container type Sterile screw top container
Amount to Collect 3 mL
Sample type CSF
Preferred volume 3 mL
Min. Volume 1 mL
Processing notes Freeze specimen and transport to CB frozen. Order Quest code 17697.
Units ng/mL
Normal range
Synonyms Tuberculosis
Stability Room temperature 1 day, refrigerated 3 days, frozen 6 months
Turn around times 3 - 5 days
Additional information Although Adenosione deaminase (ADA) is suggested as a surrogate marker for Tuberculosis, it is not specific for that disease. Elevated levels of ADA may also be seem in other forms of granulomatous inflammation as well as liver cirrhosis, liver fibrosis, certain malignancies (e.g. lymphoma), viral hepatitis, and autoimmune diseases (e.g. SLE, rheumatoid arthritis).

The sensitivity and specificity of ADA for tuberculosis are generally listed as 78-100% and 85-97% respectively. Using 95% for both sensitivity and specificity and a prevalence of tuberculosis in San Francisco of 15/100,000 (0.015%) the test has a negative predictive value of 100% but a positive predictive value of only 0.28%. Therefor the ADA is a poor test to diagnose tuberculosis although it may be useful in ruling it out.
CPT coding 84311-90
Last Updated 7/6/2015 8:32:54 AM
Entry Number 1593
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