Key words: Tuberculous pleuritis, BCG, Adenosine deaminase

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Key words: Tuberculous pleuritis, BCG, Adenosine deaminase

Fig. 1 Reciprocal antibody titers in pleural fluids obtained from patients with and without tubercu- losis

Fig. 2 Optical density in serum standards as measured by enzyme-linked immunosorbent assay. The mean }standard deviation (bars) from 5 experiments are shown on semilogarithmic scale. Open circles, pooled normal sera; closed circles, Fig. 3 Detection of BCG antigens in 39 pleural fluids by enzyme-linked immunosorbent assay in patients with tuberculous pleuritis and controls pooled normal sera boiled for 3min. without tuberculosis Fig. 4 Pleural fluid adenosine deaminase activity in pleural fluids obtained from patients with and

7) Yoshitake, S., Imagawa, M., Ishikawa, E., Nitsu, Y., Urushizaki, I., Nishiura, ER, Kanazawa, R., Kurosaki, H., Tachibana, S., Nakaz- awa, N. & Ogawa, H.: Mild and efficient conjugation of rabbit fab' and horseradish peroxidase using a maleimide compound and its use for enzyme immunoassay. J. Biochem., 92: 1413-1424, 1982. 8) Martensson, G., Pettersson, K. & Thiringer, G.: Differentiation between malignant and non- pleural effusion. Eur. J. Respir. Dis., malignant 67: 326-334, 1985. 10) Benjamin, R. G., Debanne, S. M., Ma, Y. & Daniel, T.M. : Evaluation of mycobacterial antigens in an enzyme-linked immunosorbent assay (ELISA) for the serodiagnosis of tuberculosis. J. Med. Microbiol., 18 : 309-318, 1984. 11) Winters, W. D. & Cox, R. A.: Serodiagnosis of 1) Winkelman, M. & Pfitzer, P.: Blind pleural biopsy in combination with cytology of pleural effusions. Acta Cytol., 25: 373-376, 1981. 2) Sinha, P.K., Sinha, B. B. & Sinha, A. R. S.: Diagnosing tuberculous pleural effusion: Comparative sensitivity of mycobacterial culture, histopathology and adenosine deaminase activity. J. Assoc. Physicians India, 33: 644-645, 1985. 3) Sada, E., Ruiz-Palacios, G. M., Lopez-Vidal, Y. & De Leon, P. S.: Detection of mycobacterial antigens in cerebrospinal fluid of patients with tuberculous meningitis by enzyme-linked immunosorbent assay. Lancet, ii: 651-652, 1983. 4) Baig, M. M. E., Pettengell, K. E., Simjee, A.E., Sathar, M.A. & Vorster, B.J. : Diagnosis of tuberculosis by detection of myobacterial antigen in pleural effusions and ascites. S. Afr. Med. J., 69 : 101-102, 1986. 5) Piras, M.A., Gakis, C. & Budroni, M. & Anderoni, G.: Adenosine deaminase activity in pleural effusions : An aid to differential diagnosis. Br. Med. 2: 1751-1752. 1978. tuberculosis by radioimmunoassay. Am. Rev. Respir. Dis., 124 : 582-585, 1981. 12) Straus, E. & Wu, N.: Radioimmunoassay of tuberculoprotein derived from Mycobacterium tuberculosis. Proc. Natl. Acad. Sci. U. S. A., 77: 4301-4304, 1980. 13) Krambovitis, E., Mclllmurray, M. B., Lock, P. E., Hendrickse, W. & Holzel, H.: Rapid diagnosis of tuberculous meningitis by latex particle agglutination. Lancet, 11 : 1229-1231, 1984. 14) Kadival, G. V., Samuel, A. M., Virdi, B. S., Kale, R. N. & Ganatra, R. D.: Radioimmunoassay of tuberculous antigen. Indian J. Med. Res., 75: 765-770, 1982. 15) Krambovitis, E., Harris, M. & Hughes, D.: Improved serodiagnosis of tuberculosis using two assay test. J. Clin. Pathol., 39: 779-785, 1986. 16) Doskeland, S. O. & Berdal, B. P.: Bacterial antigen detection in body fluids: Methods for rapid antigen concentration and reduction of nonspecific reactions. J. Clin. Microbiol., 11: 380-384, 1980. 17) Fujita, S., Matubara, F. & Matsuda, T.: Enzyme-linked immkunosorbent assay mea- surement of fluctuations in antibody titer and

antigenemia in cancer patients with and without candidiasis. J. Clin. Microbiol., 23: 568 18) Parkman, R., Gelfand, E.W., Rosen, F.S., Sanderson, A. & Hirschhorn, R.: Severe combined immunodeficiency and adenosine deaminase deficiency. N. Eng. J, Med., 292: 714 19) Piras, M. A. & Gakis, C.: Cerebrospinal fluid adenosine deaminase activity in tuberculous menigitis. Enzyme, 14: 311-317, 1973. BCG Antigens and Adenosine Deaminase Activity in Pleura Fluids Obtained from Patients with and without Tuberculosis Shinichi FUJITA, Tomotaka YASHIDA & Fujitugu MATSUBARA Central Clinical Laboratory, Kanazawa University School of Medicine An enzyme-linked immunosorbent assay was examined for its usefulness in detecting BCG antigens in pleural fluids from patients with and without tuberculosis. Adenosine deaminase (ADA) activity in pleural fluids was also measured. Concentrations of BCG antigens in pleural fluids from 34 patients without tuberculosis and 2 patients with the presumptive diagnosis of tuberculous pleuritis was 6ng/ml or less. On the other band, pleural fluids from 3 patients were positive for Mycobacterium tuberculosis and their concentrations of BCG antigens was 18ng/ml or greater. ADA activity of pleural fluid was found significantly high (p<0.01) in 5 patients with the presumptive and the definitive diagnosis of tuberculous pleural effusion (84.4 }35.4 IU/l) comparing with the 34 with non-tuberculous effusion (19.1 }10.6 IU/l). Comparing with the results of detecting BCG antigens, the estimation of ADA activity in pleural fluids proved more sensitive, simple, and rapid for diagnosing tuberculous pleuritis.