{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:10:44Z","timestamp":1790381444734,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,12,7]],"date-time":"2017-12-07T00:00:00Z","timestamp":1512604800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>A follow\u2010up thoracentesis is proposed in suspected atypical tuberculosis cases. The study aimed to define the variability of pleural <jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content> values across repeated thoracenteses in different types of pleural effusions (<jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>s) and to evaluate whether <jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content> variance, in regard to the cutoff value of 40 U\/L, affected final diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 131 patients with <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>s of various etiologies underwent three repeated thoracenteses. <jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content> values were subsequently estimated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>82% and 55% of patients had greater than 10% and 20% deviation from the highest <jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content> value, respectively. From those patients who had a variance of 20%, 36% had only increasing <jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content> values, while 19% had only decreasing values. Considering the cutoff value of 40 U\/L, only in two cases, <jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content> decreased below this threshold, which concerned a man with tuberculous pleurisy and a woman with lymphoma both in the course of treatment. Furthermore, only in two cases with rising values, <jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content> finally exceeded the cutoff limit, which concerned a man with rheumatoid pleurisy and a man with tuberculous pleurisy. Surprisingly, malignant <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>s (<jats:styled-content style=\"fixed-case\">MPE<\/jats:styled-content>s) showed a higher percentage of increasing values compared to all other exudates that did not, however, exceed the threshold.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The determination of pleural <jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content> levels is a reproducible method for rapid tuberculosis diagnosis. The detected measurement deviations do not appear to affect final diagnosis. In specific situations, repeated <jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content> measurements may be valuable in directing further diagnostic evaluation. More investigation is needed to elucidate the possible prognostic significance of the increasing trend in <jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content> values in <jats:styled-content style=\"fixed-case\">MPE<\/jats:styled-content>s.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcla.22371","type":"journal-article","created":{"date-parts":[[2017,12,8]],"date-time":"2017-12-08T04:48:52Z","timestamp":1512708532000},"source":"Crossref","is-referenced-by-count":5,"title":["Repeatability of pleural adenosine deaminase measurements in diagnostic evaluation of pleural effusions"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5219-6971","authenticated-orcid":false,"given":"Ourania S.","family":"Kotsiou","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine School of Medicine University of Thessaly  Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiota","family":"Tzortzi","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine School of Medicine University of Thessaly  Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafailia A. A.","family":"Beta","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Biotechnology University of Thessaly  Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Kyritsis","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Biotechnology University of Thessaly  Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos I.","family":"Gourgoulianis","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine School of Medicine University of Thessaly  Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,12,7]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1183\/09031936.93.03091098","article-title":"Diagnostic value of adenosine deaminase activity in tuberculous effusions","volume":"3","author":"Gourgoulianis KI","year":"1990","journal-title":"Eur Respir J"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-2143(96)90182-1"},{"key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"5448","DOI":"10.1016\/S0021-9258(17)33080-6","article-title":"Human adenosine deaminase. Distribution and properties","volume":"25","author":"Weyden MB","year":"1976","journal-title":"J Biol Chem"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2010.01723.x"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.120.2.356"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.03.00017103a"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.109.2.414"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2303.1994.tb00124.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2010.03.011"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.03.00051603"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.06-2063"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.55.5803"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-014-0697-y"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.12.0236"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2008.12.023"},{"key":"e_1_2_7_17_1","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1183\/09031936.93.03050586","article-title":"Low value of adenosine deaminase in tuberculous pleural effusions","volume":"3","author":"Querol JM","year":"1990","journal-title":"Eur Respir J"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.126.6.1933"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-77-4-507"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.3109\/23744235.2015.1019919"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.14.0257"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-13-546"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.4046\/trd.2002.53.5.530"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.50.6.600"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.115.1.26"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAJ.0000000000000260"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/1749-8090-9-118"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00408-016-9891-2"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1159\/000084047"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00408-007-9042-x"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2011.02053.x"}],"container-title":["Journal of Clinical Laboratory Analysis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjcla.22371","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcla.22371","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T00:22:50Z","timestamp":1695514970000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcla.22371"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,7]]},"references-count":30,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018,6]]}},"alternative-id":["10.1002\/jcla.22371"],"URL":"https:\/\/doi.org\/10.1002\/jcla.22371","archive":["Portico"],"relation":{},"ISSN":["0887-8013","1098-2825"],"issn-type":[{"value":"0887-8013","type":"print"},{"value":"1098-2825","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,12,7]]},"article-number":"e22371"}}