[The usefulness of adenosine deaminase determination in biological fluids for tuberculosis diagnosis]. / L'intérêt du dosage de l'adénosine désaminase dans les liquides biologiques au cours d'une tuberculose.

Tuberculosis may affect several organs and its prevalence is continuously increasing. Laboratory diagnosis still remains difficult. Adenosine deaminase (Ada) is an enzyme which contributes to purine metabolism and its presence in lymphocyte, monocyte and macrophage cells is associated with T cells mediated immunity. Many studies have shown the usefulness of Ada determination in various biological fluids for the diagnosis of tuberculosis. In pleural fluid, cutoff vary from 33 to 48 U/L, with sensitivity higher than 80% and specificity near 100%. In peritoneal fluid the cutoff value is 30 U/L. In cerebrospinal fluid, the value of 7 U/L can make discriminate negative and positive cases with a good sensitivity and specificity. The data from the literature show that 50 U/L in pericardic fluid is a reliable threshold for tuberculosis diagnosis. Ada determination in serum is not as relevant as in others fluids because of its low specificity. Ada measurement in biological fluids, easy and not expensive, may be add to other biological tests for tuberculosis diagnosis.

[Prolonged succinylcholine-induced apnoea associated with cholinesterase silent plasma variant]. / Curarisation prolongée à la succinylcholine liée à un variant silencieux de la cholinestérase plasmatique.

Mivacurium and succinylcholine are short-acting neuromuscular blocking drugs. The duration of their action depends on their rapid hydrolysis by plasma cholinesterase or butyrylcholinesterase. More than thirty genetic variants of this enzyme have been described but the atypical variant is the most frequently involved in prolonged apnoea following the administration of these two myorelaxants. We present one case of patient who presented a five hours long apnoea associated with null cholinesterase activity and detection of a butyrylcholinesterase silent variant (Sil-1, 1 for 100,000 persons in population) after sequencing.