Performance of CBNAAT on Pleural Biopsies Obtained by Semirigid Thoracoscopy for Diagnosis of Unexplained Pleural Effusion: A Prospective Study from North India.

Autor:	Mehfooz N; Assistant Professor, Department of Pulmonary Medicine, SKIMS, Soura, Srinagar, Jammu and Kashmir, India, Corresponding Author., Sheikh AR; Senior Resident, Department of General Medicine, SKIMS, Soura, Srinagar, Jammu and Kashmir, India., Khan UH; Associate Professor, Department of Geriatric Medicine, SKIMS, Soura, Srinagar, Jammu and Kashmir, India., Siraj F; Assistant Professor, Department of General Medicine, SKIMS, Soura, Srinagar, Jammu and Kashmir, India., Basheer G; Professor, Department of Microbiology, SKIMS, Soura, Srinagar, Jammu and Kashmir, India., Syed B; Professor and Head, Department of Pathology, SKIMS, Soura, Srinagar, Jammu and Kashmir, India., Shabir A; Ex-Assistant Professor, Department of Geriatric Medicine, SKIMS, Soura, Srinagar, Jammu and Kashmir, India., Mantoo S; Assistant Professor, Department of General Medicine, SKIMS, Soura, Srinagar, Jammu and Kashmir, India., Qadri M; Associate Professor, Department of General Medicine, SKIMS, Soura, Srinagar, Jammu and Kashmir, India., Shah S; Professor and Head, Department of Internal and Pulmonary Medicine, SKIMS, Soura, Srinagar, Jammu and Kashmir, India.
Jazyk:	angličtina
Zdroj:	The Journal of the Association of Physicians of India [J Assoc Physicians India] 2024 Mar; Vol. 72 (3), pp. 14-17.
DOI:	10.59556/japi.72.0333
Abstrakt:	Background: Exudative pleural effusions are commonly encountered in clinical practice, but in about one-fourth of cases, etiology remains elusive after initial evaluation. Medical thoracoscopy with semirigid thoracoscope is a minimally invasive procedure with high diagnostic yield for diagnosing pleural diseases, especially these undiagnosed exudative pleural effusions. In tubercular endemic areas, often, these effusions turn out to be tubercular, but the diagnosis of tubercular pleural effusion is quite challenging due to the paucibacillary nature of the disease. Although culture is the gold standard, it is time-consuming. Cartridge-based nucleic acid amplification test (CBNAAT) is a novel rapid diagnostic test for tuberculosis (TB) and has been recommended as the initial diagnostic test in patients suspected of having extrapulmonary TB (EPTB). Materials and Methods: We conducted a prospective observational study of 50 patients with undiagnosed pleural effusion admitted to our tertiary care hospital. The primary aim of the study is to evaluate the diagnostic performance of CBNAAT on thoracoscopic guided pleural biopsy and compare it with conventional diagnostic techniques like histopathology and conventional culture. Results: Of 50 undiagnosed pleural effusions, TB (50%) was the most common etiology. The overall diagnostic yield of semirigid thoracoscopy in this study was 74%. Our study showed that CBNAAT of pleural biopsies had a sensitivity of 36% only but a specificity of 100%. The sensitivity of CBNAAT was not far superior to the conventional culture. Conclusion: Tuberculosis (TB) is a common cause of undiagnosed pleural effusion in our set-up. CBNAAT testing of pleural biopsy, though, is a poor rule-out test for pleural TB, but it may aid in the early diagnosis of such patients. (© Journal of the Association of Physicians of India 2024.)
Databáze:	MEDLINE
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