scholarly journals The Differential Diagnostic Values of Cytokine Levels in Pleural Effusions

2005 ◽  
Vol 2005 (1) ◽  
pp. 2-8 ◽  
Author(s):  
Saadet Akarsu ◽  
A. Nese Citak Kurt ◽  
Yasar Dogan ◽  
Erdal Yilmaz ◽  
Ahmet Godekmerdan ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Pleural Effusion ◽  
Pleural Fluid ◽  
Parapneumonic Effusion ◽  
Pleural Effusions ◽  
Tuberculous Pleural Effusion ◽  
Cytokine Levels ◽  
Diagnostic Values

The aim is to examine whether the changes in pleural fluid interleukin (IL)-1β, IL-2, IL-6, and IL-8 levels were significant in differential diagnosis of childhood pleural effusions. IL-1β, IL-2, IL-6, and IL-8 levels in pleural fluids of all 36 patients were measured. The levels of IL-1β, IL-2, IL-6, and IL-8 in pleural fluids were statistically significantly higher in the transudate group compared with those of the exudate group. The levels of IL-1β, IL-6, and IL-8 were also found to be statistically significantly higher in the empyema group compared with both the parapneumonic and the tuberculous pleural effusion groups. The levels of IL-2 and IL-6 were detected to be statistically significantly higher in the tuberculous pleural effusion group in comparison with those of the parapneumonic effusion group. The results showed that pleural fluids IL-1β, IL-2, IL-6, and IL-8 could be used in pleural fluids exudate and transudate distinction.

scholarly journals Potential diagnostic value of pleural fluid cytokines levels for tuberculous pleural effusion

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Neda Dalil Roofchayee ◽  
Majid Marjani ◽  
Neda K. Dezfuli ◽  
Payam Tabarsi ◽  
Afshin Moniri ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Pleural Fluid ◽  
Diagnostic Value ◽  
Parapneumonic Effusion ◽  
Pleural Effusions ◽  
Tuberculous Pleural Effusion ◽  
New Biomarkers ◽  
High Level

AbstractPatients with tuberculous pleural effusion (TPE) or malignant pleural effusions (MPE) frequently have similar pleural fluid profiles. New biomarkers for the differential diagnosis of TPE are required. We determined whether cytokine profiles in the PE of patients could aid the differential diagnosis of TPE. 30 patients with TPE, 30 patients with MPE, 14 patients with empyema (EMP) and 14 patients with parapneumonic effusion (PPE) were enrolled between Dec 2018 and 2019. The levels of interleukin (IL)-6, IL-18, IL-27, CXCL8, CCL-1 and IP-10 were determined in PE by ELISA along with measurements of adenosine deaminase (ADA). The best predictors of TPE were combined ADA.IL-27 [optimal cut-off value = 42.68 (103 U ng/l2), sensitivity 100%, specificity 98.28%], ADA [cut off value 27.5 (IU/l), sensitivity 90%, specificity 96.5%] and IL-27 [cut-off value = 2363 (pg/ml), sensitivity 96.7%, specificity 98.3%, p ≤ 0.0001]. A high level of IL-6 [cut-off value = 3260 (pg/ml), sensitivity 100%, specificity 67.2%], CXCL8 [cut-off value = 144.5 (pg/ml), sensitivity 93.3%, specificity 58.6%], CCL1 [cut-off value = 54 (pg/ml), sensitivity 100%, specificity 70.7%] and IP-10 [cut-off value = 891.9 (pg/ml), sensitivity 83.3%, specificity 48.3%] were also predictive of TPE. High ADA.IL-27, ADA and IL-27 levels differentiate between TPE and non-TPE with improved specificity and diagnostic accuracy and may be useful clinically.

scholarly journals Potential diagnostic value of pleural fluid cytokines levels for tuberculous pleural effusion

2020 ◽  
Author(s):  
Neda Dalil Roofchayee ◽  
Majid Marjani ◽  
Neda K.Dezfuli ◽  
Payam Tabarsi ◽  
Afshin Moniri ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Pleural Effusion ◽  
Pleural Fluid ◽  
Extrapulmonary Tuberculosis ◽  
Clinical Manifestations ◽  
Diagnostic Value ◽  
Pleural Effusions ◽  
Tuberculous Pleural Effusion ◽  
New Biomarkers ◽  
High Level

Abstract Background: Tuberculous pleural effusion (TPE) is one of the most common forms of extrapulmonary tuberculosis. Patients with tuberculous or malignant pleural effusions (MPE) frequently have similar clinical manifestations and pleural fluid profile. New biomarkers for the differential diagnosis of TPE are required. Objective: We sought to determine of whether cytokine profiles in the pleural effusion of patients were suitable as tools for the differential diagnosis of TPE. Methods: 30 patients with TPE, 30 patients with MPE, 14 patients with empyema and 14 patients with parapneumonic effusion were enrolled consecutively from the Masih Daneshvari Hospital, Tehran, Iran between Dec 2018-Dec 2019. The levels of interleukin (IL)-6, IL-18, IL-27, CXCL-8, CCL-1 and IP-10 were determined in pleural effusions by ELISA along with measurements of adenosine deaminase (ADA). Results: The levels of all analytes measured except IL-18 were higher in TPE compared with non-TPE subjects (all p < 0.01). The best predictors of TPE were combined ADA.IL-27 (optimal cut-off value = 42.68 103.U.ng/L2, sensitivity 100%, specificity 98.28%, p ≤ 0.0001), ADA (optimal cut off value 27.5 IU/L, sensitivity 90%, specificity 96.5%, p ≤ 0.0001) and IL-27 (optimal cut-off value = 2363 pg/ml, sensitivity 96.7%, specificity 98.3%, p ≤ 0.0001). A high level of IL-6 (optimal cut-off value = 3260 pg/ml, sensitivity 100%, specificity 67.2%, p ≤ 0.0001), CXCL-8 (optimal cut-off value = 144.5 pg/m, sensitivity 93.3%, specificity 58.6%, p ≤ 0.0001), CCL-1 (optimal cut-off value = 54 pg/mL, sensitivity 100%, specificity 70.7%, p ≤ 0.0001) and IP-10 (optimal cut-off value = 891.9 pg/mL, sensitivity 83.3%, specificity 48.3%, p = 0.0001) were also predictive of TPE. Conclusion: High ADA.IL-27, ADA and IL-27 levels differentiate between TPE and non-TPE with improved specificity and diagnostic accuracy.

scholarly journals Pleural cytokines MIF and MIP-3α as novel biomarkers for complicated parapneumonic effusions and empyema

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chia-Yu Yang ◽  
Yu-Hsuan Kuo ◽  
Min Chen ◽  
Chih-Liang Wang ◽  
Li-Jane Shih ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Characteristic Curve ◽  
Diagnostic Value ◽  
High Morbidity ◽  
Parapneumonic Effusion ◽  
Pleural Effusions ◽  
Parapneumonic Pleural Effusion ◽  
Diagnostic Values ◽  
Novel Biomarkers ◽  
Pleural Infection

AbstractPatients with complicated parapneumonic effusion (CPPE)/empyema have high morbidity and mortality, particularly when adequate management is delayed. We aimed to investigate novel dysregulated cytokines that can be used as biomarkers for infectious pleural effusions, especially for CPPE/empyema. Expression of 40 cytokines in parapneumonic effusions (PPE) was screened in the discovery phase, involving 63 patients, using a multiplex immunobead-based assay. Six cytokines were subsequently validated by enzyme-linked immunosorbent assays (ELISAs). We then used ELISA to further evaluate the diagnostic values and cutoff values of these cytokines as potential biomarkers in an expanded group that included 200 patients with uncomplicated parapneumonic effusion (UPPE), CPPE, empyema, transudates, other exudates, and malignant pleural effusion (MPE). The pleural levels of four cytokines (MIF, MIP-3α, IL-1β, ENA-78) were highest and significantly increased in CPPE/empyema compared with those in other etiologies. According to receiver operating characteristic curve analysis, the four cytokines (MIF, MIP-3α, IL-1β, and ENA-78) had areas under the curve (AUCs) greater than 0.710 for discriminating parapneumonic pleural effusion from noninfectious pleural effusions. In a comparison of nonpurulent CPPE with UPPE, logistic regression analysis revealed that pleural fluid MIF ≥ 12 ng/ml and MIP-3α ≥ 4.3 ng/ml had the best diagnostic value; MIF also displayed the highest odds ratio of 663 for nonpurulent CPPE, with 97.5% specificity, 94.44% sensitivity, and an AUC of 0.950. In conclusion, our results show that elevated MIF and MIP-3α may be used as novel biomarkers for PPE diagnosis, particularly in patients with CPPE/empyema; the findings indicate that dysregulated cytokine expression may provide clues about the pathogenesis of pleural infection.

scholarly journals Diagnostic Performance of Pleural Fluid Adenosine Deaminase for Tuberculous Pleural Effusion in a Low-Incidence Setting

2018 ◽  
Vol 56 (8) ◽  
Author(s):  
Matthew Blakiston ◽  
Weldon Chiu ◽  
Conroy Wong ◽  
Susan Morpeth ◽  
Susan Taylor
Keyword(s):  
Pleural Effusion ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Diagnostic Performance ◽  
Area Under The Curve ◽  
Pleural Effusions ◽  
Roc Curve Analysis ◽  
Predictive Values ◽  
Content Type ◽  
Tuberculous Pleural Effusion

ABSTRACT The challenges associated with diagnosing tuberculous pleural effusion have led to the use of pleural fluid adenosine deaminase (pfADA) as a biomarker for Mycobacterium tuberculosis infection. This study retrospectively reviewed the diagnostic performance of pfADA, the pleural fluid lactate dehydrogenase (LD)/ADA ratio, and combinations of these two parameters in 1,637 episodes of pleural effusion in the low-tuberculosis (TB)-incidence setting of Auckland, Aotearoa New Zealand, from between March 2008 and November 2014. The median pfADA in 57 TB pleural effusion episodes (58.1 U/liter) was significantly higher (P < 0.001) than in 1,580 non-TB pleural effusions (11.4 U/liter). The median LD/ADA ratio in TB pleural effusion (8.2) was significantly lower (P < 0.001) than in non-TB pleural effusions (30.5). The pfADA and pleural fluid LD/ADA ratio AUCROC values (that is, receiver operating characteristic [ROC] curve analysis with determination of the ROC area under the curve) were 0.93 and 0.94, respectively. The pfADA thresholds of ≥15 and ≥30 U/liter demonstrated sensitivities of 100% (95% confidence internal = 93.7 to 100) and 93.0% (83.3 to 97.2), specificities of 62.7% (60.3 to 65.0) and 87.3% (85.6 to 88.9), positive predictive values (PPVs) of 8.8% (6.9 to 11.2) and 20.9% (16.4 to 26.4), and negative predictive values (NPVs) of 100% (99.6 to 100) and 99.7% (99.3 to 99.9), respectively. LD/ADA ratio thresholds of <25 and <15 demonstrated sensitivities of 100% (93.5 to 100) and 89.1% (78.2 to 94.9), specificities of 61.6% (59.1 to 64.0) and 84.8% (82.9 to 86.5), PPVs of 8.5% (6.6 to 10.9) and 17.3% (13.3 to 22.0), and NPVs of 100% (99.6 to 100) and 99.5% (99.0 to 99.8), respectively. A combination of pfADA ≥ 30 U/liter and an LD/ADA ratio < 15 increased the specificity and PPV to 97.8% (96.9 to 98.4) and 57.3% (46.5 to 67.5) but decreased the sensitivity to 85.5% (73.8 to 92.4). The primary value of pfADA in a low-TB-incidence setting, such as Auckland, is in utilization of its high NPV.

scholarly journals Pigtail Catheter Use for Draining Pleural Effusions of Various Etiologies

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Adel Salah Bediwy ◽  
Hesham Galal Amer
Keyword(s):  
Pleural Effusion ◽  
Success Rate ◽  
Pleural Fluid ◽  
Tube Thoracostomy ◽  
Chest Drain ◽  
Parapneumonic Effusion ◽  
Pigtail Catheter ◽  
Efficacy And Safety ◽  
Malignant Effusion ◽  
Pleural Effusions

Background. Use of small-bore pigtail catheter is a less invasive way for draining pleural effusions than chest tube thoracostomy. Methods. Prospectively, we evaluated efficacy and safety of pigtail catheter (8.5–14 French) insertion in 51 cases of pleural effusion of various etiologies. Malignant effusion cases had pleurodesis done through the catheter. Results. Duration of drainage of pleural fluid was 3–14 days. Complications included pain (23 patients), pneumothorax (10 patients), catheter blockage (two patients), and infection (one patient). Overall success rate was 82.35% (85.71% for transudative, 83.33% for tuberculous, 81.81% for malignant, and 80% for parapneumonic effusion). Nine cases had procedure failure, five due to loculated effusions, and four due to rapid reaccumulation of fluid after catheter removal. Only two empyema cases (out of six) had a successful procedure. Conclusion. Pigtail catheter insertion is an effective and safe method of draining pleural fluid. We encourage its use for all cases of pleural effusion requiring chest drain except for empyema and other loculated effusions that yielded low success rate.

scholarly journals Diagnostic Accuracy of Adenosine deaminase enzyme (ADA) in the diagnosis of tuberculous pleural effusion

2020 ◽  
Vol 24 (4) ◽  
pp. 311-315
Author(s):  
Haroon Ur Rasheed ◽  
Ejaz Hassan Khan ◽  
Mohsin Shafi ◽  
Ahmad Rafiq ◽  
Ambreen Ali ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Predictive Value ◽  
Colorimetric Method ◽  
Pleural Effusions ◽  
Cross Sectional ◽  
Tuberculous Pleural Effusion ◽  
Systemic Examination

Objective: To study the diagnostic accuracy of Adenosine deaminase enzyme (ADA) in the diagnosis of tuberculous pleural effusion (TPE).Material and Methods: It was a cross-sectional descriptive study conducted in the Pulmonology departments of Lady Reading and Khyber Teaching Hospital Peshawar and department of Pathology, Khyber Medical College, Peshawar from April 2015 to Jan 2016. A total of 210 tuberculous and non-tuberculous pleural effusion patients were selected through consecutive non-probability sampling techniques. After physical and systemic examination, 3cc of pleural fluid was taken. ADA was estimated by Non-Guisti and Galanti method through the simple colorimetric method. All the data was entered in a specially designed proforma and SPSS v16 was used for statistical analysis.Results: Out of 210 tuberculous and non-tuberculous pleural effusions, the commonest cause of pleural effusion was tuberculosis followed by malignancy. In our study, Pleural fluid ADA levels have sensitivity, specificity, positive predictive value( PPV), and negative predictive value (NPV) of 95.5%, 92.3%, 92.4%, and 96% respectively in differentiating tuberculous pleural effusions from non-tuberculous lymphocytes predominant pleural effusions. Conclusion: Tuberculosis is the commonest infectious disease worldwide. A pleural fluid ADA level of ≥ 35 U/L in lymphocyte-predominant effusions makes mycobacterium tuberculosis most likely etiology. This test is not only very sensitive and specific but also it is very cheap, quick, and easy to perform by routine colorimetric method.  

scholarly journals Pleural effusion in children associated with adenovirus infection

2015 ◽  
Vol 21 (3) ◽  
pp. 78 ◽  
Author(s):  
G Tiva ◽  
M Zampoli ◽  
A Vanker
Keyword(s):  
Differential Diagnosis ◽  
Pleural Effusion ◽  
Pleural Fluid ◽  
Poor Response ◽  
Adenovirus Infection ◽  
Pleural Effusions ◽  
Viral Pathogens ◽  
Common Features

<p>Viral pathogens are rare causes of pleural effusion in children. We present two cases of pleural effusions in children associated with adenovirus infection. Hepatomegaly with transaminitis, pleural fluid lymphocytosis and poor response to antibiotics were common features. Adenovirus infection should be considered in the differential diagnosis of pleural effusion in children.</p>

scholarly journals Efficacy of procalcitonin and pentraxin-3 as early biomarkers for differential diagnosis of pleural effusions

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Anita Sharma ◽  
Apurva Agrawal ◽  
Girish Sindhwani ◽  
Ashish Sharma ◽  
Sojit Tomo ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Pleural Effusion ◽  
Pleural Fluid ◽  
Biochemical Markers ◽  
Predictive Accuracy ◽  
P Value ◽  
Pentraxin 3 ◽  
Pleural Effusions ◽  
Operating Characteristics ◽  
Diagnostic Significance

Abstract Objectives Pleural effusion, defined as an abnormal accumulation of fluid in pleural space, can be of two types: transudative and exudative. The primary aim of the study was to assess the predictive accuracy of procalcitonin (PCT) and pentraxin-3 (PTX-3) in comparison to other biochemical markers such as C-reactive protein (CRP), and adenosine deaminase (ADA) in the differential diagnosis of pleural effusions. Methods A cross-sectional analytical study was conducted on patients with pleural effusion. Multiple comparisons and receiver-operating characteristics (ROC) analyses were made to evaluate the diagnostic significance of biochemical markers. Results Sixty-six patients with exudative pleural effusion classified as malignant, tuberculous, and parapneumonic effusions (malignant pleural effusion [MPE], tuberculous [TPE], and parapneumonic [PPE]) were included. Significant differences in pleural fluid levels in both PCT (p-value: 0.001) and PTX-3(p-value: 0.001), as well as serum levels of PCT (p-value: 0.001), were observed between the three groups. ROC analysis showed both PTX-3 and PCT having favorable discrimination ability with high sensitivity (≥90%) and specificity to predict PPE from TPE and MPE. Conclusions Evaluation of serum and pleural fluid PCT and levels of PTX-3 in the pleural fluid may be used as an early biomarker to differentiate the etiology of pleural effusion.

Sign in / Sign up

Export Citation Format

Share Document