| Pearls and myths in pleural fluid analysis. | |
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MedLine Citation:
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PMID: 20573057 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Virtually all patients with a newly discovered pleural effusion should undergo thoracentesis to aid in diagnosis and management. The routine pleural fluid (PF) evaluation usually includes the following: cell count and differential; tests for protein, LDH, glucose, adenosine deaminase, cytology and, if infection is a concern, pH and bacterial and mycobacterial cultures. Distinguishing transudates from exudates with Light's criteria is a pragmatic first step. If the effusion is an exudate, various PF tests have proven diagnostic utility: adenosine deaminase levels >35 IU/L usually indicate tuberculosis in lymphocyte-predominant PF; pH < 7.2 or glucose less than 60 mg/dL allow the clinician to identify complicated parapneumonic effusions; and conventional cytology may reveal malignant cells in 60% of the patients with malignant effusions. A number of optional PF tests may complement the diagnostic approach to an undiagnosed pleural effusion. For example, natriuretic peptide assays significantly improve the accuracy of a diagnosis of cardiac pleural effusion, whereas PF mesothelin levels greater than 20 nmol/L are highly suggestive of mesothelioma. |
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Authors:
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José M Porcel |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Respirology (Carlton, Vic.) Volume: 16 ISSN: 1440-1843 ISO Abbreviation: Respirology Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2011-04-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9616368 Medline TA: Respirology Country: Australia |
Other Details:
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Languages: eng Pagination: 44-52 Citation Subset: IM |
Copyright Information:
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© 2010 The Author. Journal compilation © 2010 Asian Pacific Society of Respirology. |
Affiliation:
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Pleural Diseases Unit, Department of Internal Medicine, Arnau de Vilanova University Hospital, Institut de Recerca Biomèdica de Lleida, Lleida, Spain. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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