Publication:

A study of pleural effusion with reference to different diagnostic modalaties

Background Aim of current study was to determine the different etiologies of pleural effusion and efficacy of diagnostic methods.

Methods 100 patients of pleural effusion of both sexes were taken randomly coming to our institution either indoor or OPD. Inclusion criteria: 100 patients of pleural effusion of any age and of either sex in whom thoracentesis can yield minimum amount of pleural fluid for diagnostic purposes. Exclusion criteria: Patients of pleural effusion in whom fluid could not be aspirated were excluded from the study.

Results In this study 70% of the patients were male and 30% were female. Most of the patients were between 21-30 years of age. 92% of the pleural effusion was exudative and 8% was transudative. Tuberculosis is the most common (44%) cause of pleural effusion followed by malignancy (23%), 5% of the patients remains undiagnosed. Sensitivity, specificity, NPV, PPV of Light’s criteria is 100% to differentiate between transudates and exudates. Among parameters of Light's criteria pleural LDH has highest specificity (100) and sensitivity (100) and NPV (80%). Sensitivity, specificity, NPV, PPV of ADA to differentiate between tuberculous and non tuberculous pleural effusion is 100%, 95%, 100%, 96.77% respectively. Pleural biopsy was positive in 80% of the tuberculous patients while in malignancy it was positive only in 20% of the patients.

Conclusions Tuberculosis remains to be main cause of pleural effusion in India. Light’s criteria is most specific & sensitive to diagnose between exudative & transudative pleural fluid. ADA is highly sensitive & specific to differentiate between tuberculous & nontuberculous pleural effusion. In centres where thorascopy is not available for undiagnostic cases of pleural effusion, pleural biopsy can be helpful in fair no. of cases for diagnosis.