Are pleural fluid parameters related to the development of residual pleural thickening in tuberculosis?

Chest. 1997 Nov 5;112(5):1293-7. doi: 10.1378/chest.112.5.1293.

Abstract

Study objective: Identification of predictive factors for the development of residual pleural thickening (RPT).

Design: Retrospective study.

Location: A 1,500-bed tertiary hospital.

Patients: Patients with pleural tuberculosis diagnosed between December 1991 and February 1995 in our Respiratory Disease Service.

Interventions: The clinical and radiologic characteristics, and measurements of microbiological and biochemical parameters and markers in pleural fluid were studied. RPT was defined in a posteroanterior chest radiograph as a pleural space of >2 mm measured in the lower lateral chest at the level of an imaginary line intersecting the diaphragmatic dome.

Measurements and results: In 56 patients studied, 11 (19.6%) had RPT 10 mm and 24 (42.8%) had RPT >2 mm. The pleural fluid of patients with RPT 10 mm had a significantly lower glucose concentration and pH and higher lysozyme and tumor necrosis factor-alpha levels than the other patients. The pleural fluid of patients with RPT >2 mm showed no significant differences.

Conclusions: The development of RPT 10 mm was related to higher concentrations of lysozyme and tumor necrosis factor-alpha and lower glucose concentration and pH in pleural fluid compared with development of lower measurements of RPT.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antitubercular Agents / therapeutic use
  • Biomarkers
  • Exudates and Transudates / cytology
  • Exudates and Transudates / metabolism
  • Female
  • Glucose / metabolism*
  • Humans
  • Hydrogen-Ion Concentration
  • Male
  • Middle Aged
  • Muramidase / metabolism*
  • Observer Variation
  • Pleura / diagnostic imaging
  • Pleural Effusion / etiology*
  • Pleural Effusion / metabolism
  • Pleural Effusion / therapy
  • Radiography
  • Radioimmunoassay
  • Retrospective Studies
  • Thoracostomy
  • Tuberculosis, Pleural / complications*
  • Tumor Necrosis Factor-alpha / metabolism*

Substances

  • Antitubercular Agents
  • Biomarkers
  • Tumor Necrosis Factor-alpha
  • Muramidase
  • Glucose