Role of pleural fluid cholesterol in differentiating transudative from exudative pleural effusion.

Autor:	Guleria R; Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. randeepg@hotmail.com, Agarwal SR, Sinha S, Pande JN, Misra A
Jazyk:	angličtina
Zdroj:	The National medical journal of India [Natl Med J India] 2003 Mar-Apr; Vol. 16 (2), pp. 64-9.
Abstrakt:	Background: Pleural fluid cholesterol has been reported to be useful in distinguishing between transudative and exudative pleural effusion. However, the difference in lipid profile between tubercular and non-tubercular pleural effusion has not been studied. Methods: The lipid profile of pleural fluid in 50 patients with exudative (25 tubercular and 25 non-tubercular) and 25 with transudative effusion was studied. The diagnosis was based on clinical criteria and/or a positive diagnosis from another site. Results: The criteria that best identified an exudative pleural effusion were pleural fluid cholesterol > or = 60 mg/dl, pleural fluid to serum cholesterol ratio > or = 0.4, pleural fluid triglyceride > or = 40 mg/dl and pleural fluid to serum triglyceride ratio > or = 0.3. Pleural fluid cholesterol had a sensitivity of 88% and a specificity of 100% for exudates with an accuracy of 92%. Pleural fluid to serum cholesterol ratio had a sensitivity of 98% and a specificity of 84%. These results were superior to the criteria proposed by Light et al. (sensitivity 98% and specificity 80%). Conclusion: Pleural fluid cholesterol estimation is an effective and cost-efficient method of differentiating exudative from transudative pleural effusion. The lipid profile does not help in diagnosing tubercular effusion.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu