Role of C-reactive protein in discriminating complicated and uncomplicated parapneumonic effusion from malignant and tuberculous pleural effusion

2021 ◽  
Author(s):  
Yana Kogan ◽  
Edmond Sabo ◽  
Majed Odeh
Keyword(s):  
Pleural Effusion ◽  
Parapneumonic Effusion ◽  
C Reactive Protein ◽  
Tuberculous Pleural Effusion ◽  
Reactive Protein

scholarly journals Diagnostic Value of C-Reactive Protein in Discrimination between Uncomplicated and Complicated Parapneumonic Effusion

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 829
Author(s):  
Yana Kogan ◽  
Edmond Sabo ◽  
Majed Odeh
Keyword(s):  
Area Under The Curve ◽  
Diagnostic Value ◽  
Parapneumonic Effusion ◽  
C Reactive Protein ◽  
Diagnostic Efficacy ◽  
Reactive Protein ◽  
Significant Difference ◽  
Study Population ◽  
Complicated Parapneumonic Effusion

Objectives: The role of serum C-reactive protein (CRPs) and pleural fluid CRP (CRPpf) in discriminating uncomplicated parapneumonic effusion (UCPPE) from complicated parapneumonic effusion (CPPE) is yet to be validated since most of the previous studies were on small cohorts and with variable results. The role of CRPs and CRPpf gradient (CRPg) and of their ratio (CRPr) in this discrimination has not been previously reported. The study aims to assess the diagnostic efficacy of CRPs, CRPpf, CRPr, and CRPg in discriminating UCPPE from CPPE in a relatively large cohort. Methods: The study population included 146 patients with PPE, 86 with UCPPE and 60 with CPPE. Levels of CRPs and CRPpf were measured, and the CRPg and CRPr were calculated. The values are presented as mean ± SD. Results: Mean levels of CRPs, CRPpf, CRPg, and CRPr of the UCPPE group were 145.3 ± 67.6 mg/L, 58.5 ± 38.5 mg/L, 86.8 ± 37.3 mg/L, and 0.39 ± 0.11, respectively, and for the CPPE group were 302.2 ± 75.6 mg/L, 112 ± 65 mg/L, 188.3 ± 62.3 mg/L, and 0.36 ± 0.19, respectively. Levels of CRPs, CRPpf, and CRPg were significantly higher in the CPPE than in the UCPPE group (p < 0.0001). No significant difference was found between the two groups for levels of CRPr (p = 0.26). The best cut-off value calculated by the receiver operating characteristic (ROC) analysis for discriminating UCPPE from CPPE was for CRPs, 211.5 mg/L with area under the curve (AUC) = 94% and p < 0.0001, for CRPpf, 90.5 mg/L with AUC = 76.3% and p < 0.0001, and for CRPg, 142 mg/L with AUC = 91% and p < 0.0001. Conclusions: CRPs, CRPpf, and CRPg are strong markers for discrimination between UCPPE and CPPE, while CRPr has no role in this discrimination.

scholarly journals The Diagnostic Value of the Pleural Fluid C-Reactive Protein in Parapneumonic Effusions

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Shimon Izhakian ◽  
Walter G. Wasser ◽  
Benjamin D. Fox ◽  
Baruch Vainshelboim ◽  
Mordechai R. Kramer
Keyword(s):  
Heart Failure ◽  
Pleural Effusion ◽  
Pleural Fluid ◽  
Predictive Value ◽  
Medical Center ◽  
Diagnostic Value ◽  
Parapneumonic Effusion ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Sensitivity Specificity

Purpose. The aim of this study was to evaluate the sensitivity of pleural C-reactive protein (CRP) biomarker levels in identifying parapneumonic effusions.Methods. A single-center, retrospective review of 244 patients diagnosed with pleural effusions was initiated among patients at the Rabin Medical Center, Petah Tikva, Israel, between January 2011 and December 2013. The patients were categorized into 4 groups according to their type of pleural effusion as follows: heart failure, malignant, post-lung transplantation, and parapneumonic effusion.Results. The pleural CRP levels significantly differentiated the four groups (p<0.001) with the following means: parapneumonic effusion,5.38±4.85 mg/dL; lung transplant,2.77±2.66 mg/dL; malignancy,1.19±1.51 mg/dL; and heart failure,0.57±0.81 mg/dL. The pleural fluid CRP cut-off value for differentiating among parapneumonic effusions and the other 3 groups was 1.38 mg/dL. The sensitivity, specificity, positive predictive value, and negative predictive value were 84.2%, 71.5%, 37%, and 95%, respectively. A backward logistic regression model selected CRP as the single predictor of parapneumonic effusion (OR = 1.59, 95% CI = 1.37–1.89).Conclusions. Pleural fluid CRP levels can be used to distinguish between parapneumonic effusions and other types of exudative effusions. CRP levels < 0.64 mg/dL are likely to indicate a pleural effusion from congestive heart failure, whereas levels ≥ 1.38 mg/dL are suggestive of an infectious etiology.

scholarly journals Role of Pleural Fluid C-Reactive Protein in the Aetiological Diagnosis of Exudative Pleural Effusion

2020 ◽  
Author(s):  
Praveen Radhakrishnan ◽  
S Mathanraj
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Cross Sectional Study ◽  
Direct Access ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Aetiological Diagnosis ◽  
Exudative Pleural Effusion

Introduction: Pleural effusions, the result of the accumulation of fluid in the pleural space, are a major diagnostic problem due to its anatomical nature with no direct access. There is variation in management, depending on the pleural disease. The pleural effusion can either exhibit specific or nonspecific characteristics. Aim: To determine the clinical significance and diagnostic role of pleural fluid C-Reactive Protein (CRP) level in the aetiological diagnosis of exudative pleural effusion. Materials and Methods: This was a cross-sectional study performed during the study period of September 2013 to December 2014. A total of 53 Patients identified with pleural effusion were recruited in the study and pleural fluid was subjected for the measurement of CRP level. Pleural fluid CRP was assessed with CRP-Turbilatex-Quantitative turbidimetric immunoassay method which is based on the principle agglutination reaction. The data was subjected to statistical analysis using Epi info software version 3.4.3. The Receiver Operating Characteristic (ROC) curve was plotted to illustrate the diagnostic ability. The smallest cut-off value was the minimum observed test value minus 1, and the largest cut-off value was the maximum observed test value plus 1. All the other cut-off values were the averages of two consecutive ordered observed test values. Results: Among the 53 patients in the study, 42 had exudative effusions (79.20%) and 11 had transudative effusions (20.80%). The common cause of exudative effusion was tuberculosis 26 (61.90%), followed by 9 malignancy (21.40%) and 7 parapneumonic effusion (16.70%). In our study, the pleural fluid CRP was statistically significant (p<0.001) marker to differentiate exudative effusions with CRP-value <30 suggestive of malignancy, CRP-value 30-50 mg/L suggestive of tuberculosis and CRP-value >70 mg/L suggestive of parapneumonic effusions. Conclusion: Determination of pleural fluid CRP is a useful diagnostic marker for differentiating exudative and transudative effusions. Also, Pleural fluid CRP is a statistically significant marker in differentiating tubercular effusions from nontubercular exudative effusions.

A study to assess the role of C reactive protein as a marker in diagnosing pleural effusion

2021 ◽  
Vol 6 (3) ◽  
pp. 169-172
Author(s):  
Raghurama Sharvegar ◽  
Chandrik Babu S R
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
General Medicine ◽  
Cross Sectional Study ◽  
Respiratory Medicine ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Specificity And Sensitivity

The cause of pleural effusion is due to systemic or localized pathology and based on the etiology involved the pleural effusion is either classified into transudate and exudate supported by Light’s Criteria. Other than the marker used in Lights Criteria C reactive protein is said to be studied to determine its role in classifying exudate and transudate. The present study was done to assess the role of C reactive protein in diagnosing pleural effusion.The cross-sectional study was conducted by the Department of Chest and Respiratory Medicine at Chamarajanagara Institute of Medical Sciences from June 2019 to May 2020. A total of 120 cases of clinically confirmed cases of Pleural Effusion Cases were selected for the purpose of the study among the outpatient and inpatient in the Department of General Medicine and Respiratory Medicine Department. The Mean CRP of 1.05±1.09 was found to be cut off value for differentiating between transudate and exudate Pleural fluid. At the Cut off value of 1.05 CRP it was found to be having a sensitivity of 75.4% and 77.6% of sensitivity. From the present study we could conclude that the CRP Value of 1.05mg/dl was found to be having a good specificity and sensitivity in classifying the pleural fluid into transudate and exudate. Finally we could conclude that CRP can be used as a Biomarker to differentiate between Transudate and Exudate when Lights criteria falls in borderline.

Role of markers C-Reactive Protein, Procalcitonin and TREM-1 in diagnosis of infection pleural effusion

2018 ◽  
Author(s):  
Vanessa Alvarenga ◽  
Milena Acencio ◽  
Roberta Sales ◽  
Aline Silva ◽  
Jucara Silva ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Diagnosis Of Infection
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