Is the ratio of pseudocholineaterase levels in pleural fluid to serum a new parameter
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 6
Abstract
Background and objectives: 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. Objectives:To study the levels of Cholinesterase in pleural fluids of diverse etiologies,To evaluate the validity of pleural fluid cholinesterase (ChE) and its ratio with serum cholinesterase in order to differentiate between transudates and exudates, To compare this diagnostic efficacy with Light’s criteria Methods: The study was conducted in Hangal Shri Kumareshwar Hospital attached to S. Nijalingappa Medical College, Bagalkot. Study included 125 patients who had pleural effusion who met the inclusion and exclusion criteria. Duration of the study was 12 months. Results: 62 cases (50%) had transudative effusion and 63 cases (50%) had exudative effusion. The mean PChE levels in transudates was 806.26 + 516.28 U/L and in case of exudates it was 3476.11 + 1250.17 U/L. The difference between the two groups was statistically significant (p-value < 0.05). 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.
Authors and Affiliations
Dr Gopal Bajaj, Dr. Mangalvedi Vikram Vadiraja, Dr. Udit Agarwal
Keywords
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- EP ID EP375755
- DOI 10.9790/0853-1706030408.
- Views 84
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