SEQUENTIAL EVALUATION OF SERUM ADENOSINE-DEAMINASE IN PATIENTS TREATED FOR TUBERCULOSIS

Study objective: To delineate the course of serum adenosine deaminase (s-ADA) in patients with tuberculosis who are receiving effective ther apy. Setting: A medical ward and an outpatient clinic in a general hos pital. Patients: Twenty-five immunocompetent patients with pleural or pulmonary tuberculosis. Interventions: All patients received standard chemotherapeutic regimens with isoniazid, rifampin and pyrazinamide. M easurements and results: Six measurements of several variables, includ ing s-ADA, were carried out at different periods of time during the 6 months of follow-up. There were no significant differences in s-ADA va lues bet rs een sexes and there was no significant correlation with ag e or with the other variables analyzed. There was a significant declin e in the s-ADA values during the first 2 months in the patients as a w hole (p=0.04), followed by a stabilization of the s-ADA activity, This decline was due to a marked decrease in the s-ADA in the 13 patients (52%) who had initial high levels of the enzyme (p=0.03), whereas ther e were no changes in those patients with normal initial levels (p=0.27 ). Patients with increased s-ADA. activity at the time of the first me asurement reported symptoms for a longer period than patients with nor mal s-ADA (median, 15 vs 10 days; p=0.02). Conclusions: s-ADA levels i n patients with tuberculosis decrease during title initial months of e ffective treatment. Perhaps this decrease might reflect the normalizat ion of the altered lymphocyte turnover induced by tuberculosis. The me asurement of s-ADA could be of some help to evaluate the response to t herapy, particularly in those patients with increased values of alae e nzyme.