High Adenosine Deaminase Level and Erythrocyte Sedimentation Rate of Intestinal Tuberculosis Patients

Nuri Dyah Indrasari (Doctoral Program in Medical Sciences, Faculty of Medicine, Universitas Indonesia, Jl. Salemba Raya No.6, Jakarta 10430)
Marcellus Simadibrata (Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo Central General Hospital, Jl. Diponegoro No.71, Jakarta 10430)
Primariadewi Rustamadji (Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo Central General Hospital, Jl. Diponegoro No.71, Jakarta 10430)
Yusra Yusra (Department of Clinical Pathology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo Central General Hospital, Jl. Diponegoro No.71, Jakarta 10430)
Aria Kekalih (Community Medicine Department, Faculty of Medicine, Universitas Indonesia, Jl. Pegangsaan Timur No.16, Jakarta 10430)
Suhendro Suhendro (Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo Central General Hospital, Jl. Diponegoro No.71, Jakarta 10430)
Alida Roswita Harahap (Department of Clinical Pathology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo Central General Hospital, Jl. Diponegoro No.71, Jakarta 10430)
Heri Wibowo (Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jl. Salemba Raya No.6, Jakarta 10430)
Ida Parwati (Department of Clinical Pathology, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital Bandung, Jl. Pasteur No. 38, Bandung 40132)
Ferry Sandra (Department of Biochemistry and Molecular Biology, Division of Oral Biology, Faculty of Dentistry, Universitas Trisakti, Jl. Kyai Tapa No. 260, Jakarta 11440)

The Indonesian Biomedical Journal
Vol 15, No 4 (2023)

BACKGROUND: Currently, laboratory diagnosis of intestinal tuberculosis (ITB) is limited based on clinical manifestations, providing opportunities for alternative laboratory tests to diagnose ITB. At the present time, the role of serum adenosine deaminase (ADA) and hematological tests in ITB patients are not widely known. The objective of this study was to determine the role of ADA and hematological tests in patients suspected with ITB.METHODS: Subjects that were suspected of ITB were classified as ITB group, while subjects with inflammatory bowel disease, hemorrhoid, and intestinal malignancy were classified as non-ITB group. Colonoscopy, histopathological examinations, and hematological test were performed. ADA measurement was also performed with clinical chemistry analyzer based on enzymatic colorimetry principle.RESULTS: Out of 143 subjects, 16 (11.2%) subjects were diagnosed with ITB and 127 (88.8%) subjects were classified as non-ITB group. ADA level and erythrocyte sedimentation rate (ESR) of ITB group were significantly higher than the ones of non-ITB group (p<0.05). Cut-off, sensitivity, and specificity of ADA level were 12.56 IU/L, 75%, and 57%, respectively. Cut-off, sensitivity, and specificity of ESR were 32.5 mm/hour, 81%, and 62%, respectively. Colonoscopy of ITB subjects displayed multiple ulcerations, edema, and hyperemic mucosa. Histopathological examination of ITB subjects exhibited granulomatous inflammation, epitheloid cells, giant cells, and lymphocyte aggregates.CONCLUSION: ADA level and ESR were significantly higher among ITB patients compared with non-ITB patients. Since the sensitivities of ADA and ESR tests were high, the ADA and ESR tests could be considered as a screening test for ITB.KEYWORDS: intestinal tuberculosis, adenosine deaminase, hematological tests