EVALUATION OF SERUM-PLEURAL FLUID ALBUMIN GRADIENT FOR DIFFERENTIATION OF TRANSUDATE AND EXUDATE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 48
Abstract
BACKGROUND The correct diagnostic approach of any Pleural Effusion (PE) is differentiation between Transudates and Exudates. The Light’s criteria is used to differentiate between the two, but up to 25% of Transudates are misclassified as Exudates. To overcome this, the gradient between Serum (Sr.) - Pleural Fluid (PF) Albumin should be measured. A gradient of > 1.2 gm/dL has good sensitivity and specificity for confirming transudates. The aim of this study was to estimate the Sr. - PF Albumin gradient and comparing it with Light’s criteria for its efficacy in the identification of Transudates misclassified by Light’s criteria as Exudates. MATERIALS AND METHODS This is a descriptive study. It was conducted on 50 patients who had only transudative PE with the clinical background of Congestive Cardiac Failure (CCF), Chronic Kidney Disease (CKD) and Hepatic hydrothorax admitted in Medical wards of Govt. Rajaji Hospital, Madurai. RESULTS According to PF - Sr. Protein ratio in the Light’s criteria, 78% of the cases were detected as Transudative PE. According to Sr. - PF Albumin gradient, 96% of the cases were detected as Transudative PE. According to Sr. - PF Protein gradient, 88% of the cases were detected as Transudative PE. CONCLUSION By using Sr. - PF Albumin gradient, our study correctly classified 96% as Transudative PE and by applying Light’s criteria only 78% were classified as Transudative PE. So, Light’s criteria wrongly classified 22% of Transudative PE as Exudative PE, whereas Sr. - PF Albumin gradient classified only 4% of Transudative PE as Exudative PE. Sr. - PF Protein gradient correctly classified 88% of Transudative PE and wrongly classified 12% of them. From our study, it is conclusive that Sr. - PF Albumin gradient is an effective means of differentiating Exudative and Transudative PE.
Authors and Affiliations
Vasudevan Palanikumaran, Sappani Kasipandian, Manickam Natarajan
Keywords
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- EP ID EP218928
- DOI 10.14260/Jemds/2017/801
- Views 88
- Downloads 0
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