Vol. 7, Issue 3 (2018)

Author(s):
Sunik Malik, BC Sarin and PK Sehajpal

Abstract:
The diagnosis of a pleural effusion is often challenging as its formation can be an outcome of diverse diseases. A total of 53 confirmed cases of exudative pleural effusion with peripheral blood were collected, 40 with tuberculous pleurisy, and 13 with malignant etiology were included in the study. The diagnostic utility of three biochemical markers, i.e. protein, lactate dehydrogenase (LDH) and cholesterol were ascertained in the identification of exudative pleural effusion. The utility of the markers using both blood and pleural fluid were compared with pleural fluid alone. Light’s criteria is the gold standard for identifying exudative pleural effusion and was able to identify 49/53 exudates in our samples. However, only pleural fluid biochemical markers are sufficient to reach the same sensitivity and if all three markers are used the sensitivity was found to be better (50/53) than the one achieved by Light’s criteria. The limitation of collecting blood and pleural fluid needed for applying Light’s criteria in high burden and low resource countries can be avoided by choosing more than two biochemical parameters from pleural fluid alone.