TB Panel (Lungs)
3 parameters
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Acid Fast Bacilli Smear (AFB), Adenosine Deaminase (ADA), Angiotensin Converting Enzyme (ACE)
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1. Acid Fast Bacilli Smear (AFB)
🧪 What is it?
A microscopic test used to detect Mycobacterium tuberculosis and other acid-fast bacteria (AFB) in sputum, tissue, or body fluids.
❓ Why is it done?
- To diagnose tuberculosis (TB) and monitor treatment
- Screen for mycobacterial infections (pulmonary or extrapulmonary TB)
📊 Normal Range:
- Negative: No AFB seen
📈 Interpretation:
Result | Interpretation |
|---|---|
Negative | No AFB detected (may need repeat testing) |
Positive | Indicates active TB or non-TB mycobacterial infection |
🧠 Associated Conditions:
- Pulmonary TB
- Extrapulmonary TB (e.g. pleural, lymph node, bone)
- Non-TB mycobacterial infections (NTM)
🔄 Follow-up Tests:
- GeneXpert MTB/RIF
- AFB Culture & Sensitivity
- Chest X-ray / CT
- Tuberculin Skin Test (TST)
- Interferon Gamma Release Assay (IGRA)
✅ Fasting Required: ❌ No
📝 Summary:
Parameter | AFB Smear |
|---|---|
What | Detects TB-causing bacteria in samples |
Why | Diagnose and monitor TB |
Normal | Negative (no AFB seen) |
Positive | TB or other mycobacterial infection |
Fasting | ❌ No |
2. Adenosine Deaminase (ADA)
🧪 What is it?
An enzyme assay that measures ADA activity in body fluids (especially pleural, peritoneal, or CSF), linked to immune activity.
❓ Why is it done?
- Aid in diagnosis of tubercular effusions (e.g., pleural TB)
- Differentiate TB from malignancy or other causes of fluid accumulation
📊 Normal Range:
- Pleural/Peritoneal fluid:
- < 30 U/L: Unlikely TB
- > 40 U/L: Suggestive of TB
(Cut-offs may vary)
📈 Interpretation:
ADA Level | Meaning |
|---|---|
< 30 U/L | TB less likely |
> 40 U/L | TB probable |
30–40 U/L | Indeterminate – clinical correlation needed |
🧠 Associated Conditions:
- Tuberculosis (especially extrapulmonary)
- Empyema, lymphoma (can cause false positives)
- Some malignancies and infections
🔄 Follow-up Tests:
- AFB Smear/Culture
- PCR for Mycobacterium tuberculosis
- Pleural biopsy
- Imaging
✅ Fasting Required: ❌ No
📝 Summary:
Parameter | ADA |
|---|---|
What | Enzyme level in body fluids |
Why | Diagnose TB-related effusions |
Normal | <30 U/L |
High | Suggestive of TB |
Fasting | ❌ No |
3. Angiotensin Converting Enzyme (ACE)
🧪 What is it?
A blood test that measures the level of ACE, primarily used in diagnosing and monitoring sarcoidosis.
❓ Why is it done?
- Diagnose sarcoidosis (granulomatous disease)
- Monitor disease activity or treatment response
📊 Normal Range:
- Adults: 8–52 U/L
(may vary by lab and method)
📈 Interpretation:
ACE Level | Meaning |
|---|---|
Normal | No evidence of ACE overactivity |
High | Suggests sarcoidosis or other granulomatous diseases |
Low | May occur during ACE-inhibitor therapy or late sarcoidosis |
🧠 Associated Conditions:
Condition | Relevance |
|---|---|
Sarcoidosis | Elevated ACE common |
Tuberculosis | May mildly elevate ACE |
Gaucher’s disease, Leprosy, Hyperthyroidism | Less common causes |
🔄 Follow-up Tests:
- Chest X-ray / CT
- Calcium levels (often elevated in sarcoidosis)
- Serum lysozyme
- Pulmonary function tests
- Biopsy of granulomas
✅ Fasting Required: ❌ No
📝 Summary:
Parameter | ACE |
|---|---|
What | Enzyme linked to granuloma activity |
Why | Diagnose or monitor sarcoidosis |
Normal | 8–52 U/L |
High | Suggests sarcoidosis |
Fasting | ❌ No |
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