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.

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 STUDY OF PLEURAL FLUID TO SERUM CHOLINESTERASE RATIO TO DIFFERENTIATE BETWEEN TRANSUDATE AND EXUDATE AND ITS CORRELATION WITH LIGHT'S CRITERIA

2020 ◽  
pp. 29-31
Author(s):  
Manohar MR ◽  
Deepti Shetty ◽  
Vikram VM
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Clinical Condition ◽  
Mean Value ◽  
Serum Cholinesterase ◽  
P Value ◽  
Good Sensitivity ◽  
Pleural Effusions ◽  
Exclusion Criteria ◽  
The Mean

Background: Pleural effusion is a common clinical condition faced in everyday practice. The first step in the management of pleural effusion is its differentiation into transudates and exudates. Light’s criteria is the most widely used parameter to differentiate pleural effusions but studies have shown that Light’s criteria misclassifies a significant amount of cases. Methods: Study included 125 patients who had pleural effusion who met the inclusion and exclusion criteria. Duration of the study was 12 months. Results: Accordingly the mean value of this ratio was 0.10 + 0.05 in the transudates group and 0.39 + 0.14 in the exudates group. This difference was found to be statistically significant (p-value < 0.001). This ratio misclassified 5 cases. Among them 2 (3.2%) were transudates that were misdiagnosed as exudates and 3 (4.8%) were exudates that were misdiagnosed as transudates.In this study Light’s criteria misclassified 13 cases in total with a sensitivity of 91.9% and a specificity of 87.3%. Conclusions: Light’s criteria has a good sensitivity and specificity but P/S ChE was the most efficient parameter in differentiating between transudates and exudates in this study.

Telomerase activity in pleural effusions: diagnostic significance.

1998 ◽  
Vol 16 (2) ◽  
pp. 567-573 ◽  
Author(s):  
C T Yang ◽  
M H Lee ◽  
R S Lan ◽  
J K Chen
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Telomerase Activity ◽  
Pleural Effusions ◽  
Pleural Biopsy ◽  
Diagnostic Significance ◽  
Group Iii ◽  
Malignant Pleural Effusions ◽  
Group I ◽  
Group Ii

PURPOSE To determine the diagnostic value of pleural fluid telomerase activity in distinguishing a malignant from a nonmalignant pleurol effusion in a cohort of patients undergoing thoracentesis. PATIENTS AND METHODS Using a polymerase chain reaction (PCR)-based assay, telomerase activity was examined in the pleural fluid cells obtained from 144 consecutive, unselected patients. According to the final diagnosis achieved, these patients were classified into three groups: group I consisted of 70 malignant pleural effusions diagnosed by either fluid cytology or pleural biopsy, group II consisted of 52 nonmalignant pleural effusions, and another 22 samples were categorized to be suspicious malignant pleural effusions (group III) due to inconclusive results in effusion cytology and percutaneous pleural biopsy, but were strongly suspicious in clinical settings. RESULTS The presence of telomerase activity was observed in 64 of 70 samples in group I (91.4%), three of 52 samples in group II (5.8%), and 20 of 22 samples in group III. All three nonmalignant, telomerase-positive pleural effusion samples in group II were obtained from patients with tuberculosis. As a diagnostic criterion for malignant pleural effusion in group I and group II patients, positive telomerase activity had a sensitivity of 91.4%, a specificity of 94.2%, and a positive and negative predictive value of 0.96 and 0.89, respectively. CONCLUSION Our results indicate that the detection of telomerase activity may be a useful adjunct to cytopathologic methods in the diagnosis of malignant pleural effusions.

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 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 Pleural Fluid Pentraxin-3 for the Differential Diagnosis of Pleural Effusions

2013 ◽  
Vol 75 (6) ◽  
pp. 244 ◽  
Author(s):  
Chang Dong Yeo ◽  
Jin Woo Kim ◽  
Mi Ran Cho ◽  
Ji Young Kang ◽  
Seung Joon Kim ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Pleural Fluid ◽  
Pentraxin 3 ◽  
Pleural Effusions

scholarly journals ROLE OF TUMOR MARKERS IN THE DIAGNOSIS OF MALIGNANT PLEURAL EFFUSIONS

2020 ◽  
pp. 1-2
Author(s):  
Subhakar Kandi ◽  
Ajay Kumar P ◽  
Shravika Reddy Kandi
Keyword(s):  
Differential Diagnosis ◽  
Pleural Fluid ◽  
Tumor Markers ◽  
P Value ◽  
Pleural Effusions ◽  
Malignant Pleural Effusions ◽  
Tuberculous Pleurisy

As an aid in the differential diagnosis of oxidative pleural effusions tumor markers were investigated. We measured carcinoembrionic antigen (CEA) and a glycoprotein CA 15-3 in the pleural fluid of 33 patients with carcinomatous pleural effusions and of ten patients with tuberculous pleurisy and other causes because we have frequently found those diseases to be associated with exudative pleuritis. CEA and CA 15-3 were significantly higher in carcinomatous pleural fluids than in tuberculous fluids (p value of 0.0287), therefore combined assay of CEA and CA 15-3 may be useful in distinguishing pleural effusions due to malignancies from those of tuberculous origin.

Diagnostic efficacy and suitability of trans-thoracic ultrasonography for pleural fluid detection – The future non-invasive gold-standard?

2020 ◽  
Vol 13 (4) ◽  
pp. 184-190
Author(s):  
Muhammad Irfan ◽  
Abdul Rasheed Qureshi ◽  
Zeeshan Ashraf ◽  
Muhammad Amjad Ramzan ◽  
Tehmina Naeem ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Pleural Fluid ◽  
Gold Standard ◽  
Pleural Effusions ◽  
Diagnostic Efficacy ◽  
Chest Sonography ◽  
X Ray ◽  
Non Invasive ◽  
Fluid Detection

ABSTRACT Background: Conventionally Pleural effusions are suspected by history of pleuritis, evaluated by physical signs and multiple view radiography. Trans-thoracic pleural aspiration is done and aspirated pleural fluid is considered the gold-standard for pleural effusion. Chest sonography has the advantage of having high diagnostic efficacy over radiography for the detection of pleural effusion. Furthermore, ultrasonography is free from radiation hazards, inexpensive, readily available  and feasible for use in ICU, pregnant and pediatric patients. This study aims to explore the diagnostic accuracy of trans-thoracic ultrasonography for pleural fluid detection, which is free of such disadvantages. The objective is to determine the diagnostic efficacy of trans-thoracic ultrasound for detecting pleural effusion and also to assess its suitability for being a non-invasive gold-standard.   Subject and Methods: This retrospective study of 4597 cases was conducted at pulmonology  OPD-Gulab Devi Teaching Hospital, Lahore from November 2016 to July 2018. Adult patients with clinical features suggesting pleural effusions were included while those where no suspicion of pleural effusion, patients < 14 years and pregnant ladies were excluded. Patients were subjected to chest x-ray PA and Lateral views and chest ultrasonography was done by a senior qualified radiologist in OPD. Ultrasound-guided pleural aspiration was done in OPD & fluid was sent for analysis. At least 10ml aspirated fluid was considered as diagnostic for pleural effusion. Patient files containing history, physical examination, x-ray reports, ultrasound reports, pleural aspiration notes and informed consent were retrieved, reviewed and findings were recorded in the preformed proforma. Results were tabulated and conclusion was drawn by statistical analysis. Results: Out of 4597 cases, 4498 pleural effusion were manifested on CXR and only 2547(56.62%) pleural effusions were proved by ultrasound while 2050 (45.57%) cases were reported as no Pleural effusion. Chest sonography demonstrated sensitivity, specificity, PPV, NPV and diagnostic accuracy 100 % each. Conclusions: Trans-thoracic ultrasonography revealed an excellent efficacy that is why it can be considered as non-invasive gold standard for the detection of pleural effusion.

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