Adenosine deaminase

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Adenosine deaminase

Department

Chemical Pathology

Delphic Registration Code (Alpha Code)

OADA

Test Code (Numeric Code)

Laboratory Handling

Registration

ADA added to Microbiology Pleural Aspirate - ADA, ADA added to Microbiology TB sample - TADA, ADA added to Microbiology TBP sample - PADA, ADA added to Microbiology TBLP sample - LADA, ADA added to Microbiology TBRP sample - RADA

Sample Stability

6 Days 2-8°C

Synonyms

ADA

Turnaround Time

2 hours

Available 24 hours

Specimen Type

Pleural Fluid

Specimen Requirements

Tube/Container Type:

Preferred

Plain (Red Top)

Acceptable

Blood Gas Syringe
Lithium Heparin PST- Gel (Light Green Cap)

Minimum Sample Volume (ml)

Paediatric Specimen Requirements

Tube/Container Type:

Preferred

Plain(Microtainer)

Acceptable

Heparin (Microtainer)
Blood Gas Syringe

Minimum Sample Volume (ml)

0.4

Additional Specimen Information

We do not offer CSF ADA analysis.

Diagnostic Use

Pleural fluid : raised ADA can be used in the diagnosis of tuberculous pleural effusion. Elevated ADA are also found in empyema, rheumatoid pleuritis, lymphoma and post-CABG pleural effusions. Specificity for TB can be improved if lymphocyte to neutrophil ratio is >0.75.
Ascitic fluid : There are only limited literature on use of ADA in diagnosing tuberculous peritonitis. As the methods and populations studied were not well standardized, direct comparison of our results to published cut offs is not recommended. Given these limitations, educated guess would suggest a cut point around 20-35 U/L by our local method likely yield sensitivity and specificity both around 90% (no local diagnostic performance data). Other clinical findings should also be considered as its negative predictive value in excluding TB is not high especially for patients with intermediate to high clinical pre-test probability. Note that ADA can be low in cirrhotic or elderly patients regardless of presence of TB peritonitis thus if a similar cut point is used, that will result in a lower sensitivity.
Pericardial fluid : There are only limited literature on use of ADA in diagnosing tuberculous pericarditis. As the methods and populations studied were not well standardized, direct comparison of our results to published cut offs is not recommended. Given these limitations, educated guess would suggest a cut point around 30 U/L by our local method likely yield sensitivity and specificity both around 80-90% (no local diagnostic performance data). Other clinical findings should also be considered as its negative predictive value in excluding TB is not high especially for patients with intermediate to high clinical pre-test probability.
CSF : this test is NOT offered at CMH laboratory as its diagnostic value for TB meningitis is doubtful.

Reference Intervals

Pleural fluid

<30 U/L – not strongly suggestive of tuberculous effusion. However, other clinical findings should also be considered as its negative predictive value is not very high especially in intermediate to high clinical pretest probability situations.

30- 70 U/L- borderline range, value of indeterminate significance. Specificity for tuberculosis is significantly improved if the effusion is lymphocytic and empyema is excluded.

>70 U/L- highly suggestive of tuberculosis. Note that high levels can also be seen in empyema, lymphoma and rheumatoid effusion.

Ascitic fluid

No established reference intervals. Please see section under “Diagnostic Use”.

Test Method

Principle: Enzymatic Deamination
Analyser: Roche Diagnostics Cobas c703/c503
Reagent: Diazyme: Adenosine Deaminase Assay

Limitations / Interference

NOTE: this test CANNOT be used to assess reduction in circulating ADA activity e.g. in ADA-SCID (severe combined immunodeficiency) or in atypical polyarteritis nodosa (systemic vasculitis associated with ADA2 deficiency (DADA2).

Uncertainty of Measurement

10%

Last updated: 13/05/2026

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Department

Delphic Registration Code (Alpha Code)

Test Code (Numeric Code)

Laboratory Handling

Registration

Sample Stability

Synonyms

Turnaround Time

Specimen Type

Specimen Requirements

Tube/Container Type:

Preferred

Acceptable

Minimum Sample Volume (ml)

Paediatric Specimen Requirements

Tube/Container Type:

Preferred

Acceptable

Minimum Sample Volume (ml)

Additional Specimen Information

Diagnostic Use

Reference Intervals

Test Method

Limitations / Interference

Uncertainty of Measurement

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Adenosine deaminase

Overview

Department

Delphic Registration Code (Alpha Code)

Test Code (Numeric Code)

Laboratory Handling

Registration

Sample Stability

Synonyms

Turnaround Time

Specimen

Specimen Type

Specimen Requirements

Tube/Container Type:

Preferred

Acceptable

Minimum Sample Volume (ml)

Paediatric Specimen Requirements

Tube/Container Type:

Preferred

Acceptable

Minimum Sample Volume (ml)

Additional Specimen Information

Referral

Clinical Information/Test Method

Diagnostic Use

Reference Intervals

Test Method

Limitations / Interference

Uncertainty of Measurement

Price

Additional Costing Information

Additional Information

Contact Information

Contact Information

Enquiry Form

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