Mostofa Showkat Imran¹*, Mahfuza akhter², Amitav Saha², Moshfiqur Rahman Chowdhury³, Almagir Haider⁴ and Syeda Meherunnessa⁵

¹Assistant Professor, Department of Gastroenterology, Ibn Sina Medical College and Hospital, Dhaka, Bangladesh ²Assistant Professor, Department of Gastroenterology, Dhaka Medical Hospital, Dhaka, Bangladesh ³Registrar, Medical Gastroenterology Sheikh Russel National Gastro Liver Institute and Hospital, Dhaka, Bangladesh ⁴Assistant Professor, Department of Anaesthesia, Aichi Medical College and Hospital, Dhaka, Bangladesh ⁵Registrar, Department of Obstetrics and Gynecology, Ad Din Medical College and Hospital, Dhaka, Bangladesh

*Corresponding Author: Mostofa Showkat Imran, Assistant Professor, Department of Gastroenterology, Ibn Sina Medical College and Hospital, Dhaka, Bangladesh.

Received: October 31, 2023; Published: November 24, 2023

Abstract

Introduction: Abdominal tuberculosis is a type of extrapulmonary tuberculosis which involves the abdominal organs such as intestines, peritoneum and abdominal lymph nodes. In patients with disseminated tuberculosis, it can either occur in isolation or along with a primary focus. And ascites is the pathologic accumulation of fluid within the peritoneal cavity. Since many diseases can cause ascites, in particular cirrhosis. Ascitic fluid are commonly analyzed in order to develop a differential diagnosis.

Objective: The purpose of this study was to determine whether ADA helps in detecting Abdominal Tuberculosis.

Methods: This cross-sectional study was conducted in Gastroenterology department of Dhaka Medical College Hospital in collaboration with National Tuberculosis Reference Laboratory, NIDCH, Mohakhali, Dhaka from May 2015 to April 2016. A total of 73 patients with abdominal TB who met the selection criteria and attended in Gastroenterology department of DMCH either through admission or referral were enrolled in this study.

Results: The mean age of the study subject was 33.90 ± 15.14 years. Majority of the patients (53.2%) were in between 18-30 year’s age group followed by 18.8% were in between 31-40 year’s age group and lastly 28% were in between 41 to 70 year’s age group. Most common symptoms were weight loss (96.9%), abdominal pain (75%), fever (75%), loss of appetite (68.8%), night sweats (34.4%), swelling of abdomen (31.3%,), diarrhea (25%), cough and sputum (21.8%), constipation (25%), vomiting (15.6%). MTB DNA was detected in 9 (45%) patients. Diagnostic yield of Gene Xpert to detect MTB DNA on colonoscopic biopsy specimen found in 42.1% and Ultrasound guided biopsy of the L/N in 100% of patients. Histolopathogy showed epithelioid cell granulomas with or without caseation in 37.5% patients, Positive AFB on culture of tissue sample in 9.4% patients, ADA value in ascitic fluid (Cutoff >40 IU/L) in 25% patients and good clinical response to therapeutic trial anti-TB treatment found in 18.7% patients. Beside 18.7% patients were diagnosed on the basis of combination of various tests. Gene Xpert detected cases had a higher above-normal ADA level (92.2%) than Gene Xpart negative patients (14.7%).

Conclusion: We can conclude that extrapulmonary TB patients had significantly higher ADA levels. Ascitic fluid ADA can be used as a standard test in the diagnosis of tuberculosis since it is a simple, inexpensive, specific, and sensitive biomarker for disease diagnosis.

Keywords: Abdominal Tuberculosis; Ascitic Fluid; ADA; Gene Xpert; MTB DNA; Histolopathogy

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Citation

Citation: Mostofa Showkat Imran.,et al. “Study on Abdominal Tuberculosis Detecting in Ascitic Fluid with ADA Analysis in A Tertiary Care Hospital in Bangladesh".Acta Scientific Gastrointestinal Disorders 6.12 (2023): 54-58.

Copyright

Copyright: © 2023 Mostofa Showkat Imran.,et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.