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Comparative Studies | Medicine | India | Volume 12 Issue 7, July 2023
Diagnostic Value of Pleural Fluid Cholesterol versus Pleural Fluid Protein / Serum Protein Ratio to Differentiate Exudative from Transudative Pleural Effusion
Dr. Navneet Kaur [2] | Dr. Sat Pal Aloona | Dr. Kanika Kukreja | Dr. Sapna [10]
Abstract: The classification of pleural effusion is usually done on the basis of Light?s criteria as per which an exudative pleural effusion meets one of the following criteria - a) Ratio of protein in pleural fluid and serum >0.5 b) Ratio of LDH in pleural fluid to serum >0.6 c) Pleural fluid LDH > 2/3rd upper limit of serum LDH. But studies have observed that about 25% of transudative pleural effusions are misclassified as exudative using Light's criteria. The present study was conducted to determine the diagnostic value of pleural fluid cholesterol in differentiating transudative from exudative pleural effusion in comparison to Pleural fluid/Serum protein ratio. Material and methods: The present study was conducted on 50 patients with definite clinical diagnosis and pleural effusion evidenced by radiological imaging in department of Medicine, Guru Nanak Dev Hospital attached to Govt. Medical College, Amritsar. Each patient was investigated for routine investigations, Chest X - ray P. A. view, Pleural fluid protein and Pleural fluid cholesterol. Results: Out of 50 patients, 32 patients had transudative pleural effusion and 18 had exudative pleural effusion according to etiology. Using 0.5 as a cut off, pleural fluid protein/serum protein classified 42 as exudative and 8 as transudative pleural effusion. Using a cut off of 50 mg/dL, pleural fluid cholesterol classified 37 as exudative and 13 as transudative pleural effusion. The sensitivity, specificity, PPV, NPV and accuracy were found to be higher with pleural fluid cholesterol. Conclusion: Pleural fluid cholesterol is a good diagnostic tool to determine the type of pleural effusion. There is no need of simultaneous blood sampling reducing the cost and discomfort to the patient.
Keywords: Pleural effusion, pleural fluid protein to serum protein ratio, pleural fluid cholesterol
Edition: Volume 12 Issue 7, July 2023,
Pages: 1672 - 1675