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Related Experiment Videos

Lymphocyte populations in tuberculous pleural effusions.

M E San José1, L Valdés, M J Saavedra

  • 1Servicio de Análisis Clínicos, Hospital de Conxo (Complejo Hospitalario Universitario de Santiago, Spain. csgabcsc@cesga.es

Annals of Clinical Biochemistry
|August 24, 1999
PubMed
Summary

Activated T lymphocytes in pleural fluid are key indicators for diagnosing tuberculous pleuritis, outperforming peripheral blood analysis. This compartmentalization highlights the importance of local immune responses in tuberculosis diagnosis.

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Area of Science:

  • Immunology
  • Pulmonology
  • Infectious Diseases

Background:

  • Systemic and local immune responses to mycobacterial antigens suggest lymphocyte compartmentalization in tuberculosis.
  • Analyzing peripheral blood alone may inaccurately represent the immune status in pleural effusions.
  • Understanding lymphocyte distribution is crucial for accurate diagnosis of pleural diseases.

Purpose of the Study:

  • To investigate lymphocyte compartmentalization in patients with pleural effusions.
  • To evaluate the diagnostic utility of specific lymphocyte subpopulations in pleural fluid versus peripheral blood for tuberculosis.
  • To compare the efficiency of lymphocyte analysis with adenosine deaminase (ADA) determination.

Main Methods:

  • Flow cytometry was used to analyze lymphocyte subpopulations (B, T, CD4+, CD8+, CD3+DR+) in pleural fluid and peripheral blood from 140 patients.

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  • Patients were categorized into six groups based on effusion etiology: tuberculous, paraneoplastic, metapneumonic empyematous, transudate, miscellaneous exudate, and unknown.
  • Diagnostic efficiency, positive predictive value (PPV), and negative predictive value (NPV) were calculated for various markers and ratios.

    • Main Results:

    • The CD3+DR+ (activated T lymphocyte) population in pleural fluid showed 84% diagnostic efficiency for tuberculosis.
    • The pleural fluid/peripheral blood ratio of CD3+DR+ cells demonstrated 83% efficiency and significant differences across most etiological groups.
    • Activated T lymphocytes were significantly higher in pleural fluid than peripheral blood in tuberculous pleuritis, correlating with ADA levels.

    Conclusions:

    • Lymphocyte compartmentalization is confirmed in tuberculous pleuritis, with a higher concentration of activated T lymphocytes in pleural fluid.
    • Analysis of activated T lymphocytes (CD3+DR+) in pleural fluid offers significant diagnostic value for tuberculous pleuritis.
    • Pleural fluid analysis, particularly of lymphocyte subpopulations and ADA, is superior to peripheral blood analysis for diagnosing tuberculous pleuritis.