Adenosine deaminase in pleural effusion: Bridging diagnosis and the pathophysiology of inflammation

Table 3 Comparison of traditional markers and pleural adenosine deaminase for pleural effusion diagnosis

Marker/method	Pros	Cons
Light’s criteria	Standardized, non-invasive	Low specificity for inflammation etiology (e.g., cannot distinguish TB from cancer)
LDH	Sensitive for identifying exudates	Not specific to inflammation; influenced by tissue necrosis
Protein level	Used in Light’s criteria	Less discriminatory than P-ADA for differentiating inflammatory vs transudative effusions
P-ADA ≥ 9.00 U/L	High specificity and sensitivity for inflammation. Non-invasive and cost-effective	Requires validation across diverse populations. Lacks global consensus on cutoffs

LDH: lactate dehydrogenase; P-ADA: Pleural adenosine deaminase; TB: Tuberculosis.