Adenosine deaminase (ADA) enzyme is seen in high concentrations in T lymphocytes and is significantly increased in tubercular infections. At a level of 50 U/L, the assay is highly sensitive, specific with both positive and negative predictive values for Tuberculosis. However in patients with lymphocyte rich infusions from non - tubercular causes, ADA levels < 40 U/L are seen in approximately 97% cases.