Related Experiment Video
Updated: Jul 13, 2026
03:22
Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
Discrimination of exudative pleural effusions based on multiple biological parameters
Z D Daniil1, E Zintzaras, T Kiropoulos
1Department of Respiratory Medicine, University of Thessaly School of Medicine, Larissa, Greece.
The European Respiratory Journal
|August 11, 2007
Summary
Diagnosing pleural effusion can be challenging. This study found that measuring adenosine deaminase (ADA) and C-reactive protein (CRP) levels in pleural fluid effectively distinguishes between malignant, parapneumonic, and tuberculous effusions.
Area of Science:
- Pulmonary Medicine
- Biomarker Discovery
- Diagnostic Testing
Background:
- Pleural effusion is a frequent complication across various diseases.
- Conventional diagnostic methods often fail to determine the underlying cause of pleural effusion.
- There is a need for alternative diagnostic tests to differentiate pleural effusion types.
Purpose of the Study:
- To investigate the utility of seven biological markers for discriminating between malignant, parapneumonic, and tuberculous pleural effusion.
- To identify key biomarkers that can effectively differentiate these three common types of pleural effusion.
Main Methods:
- Measured concentrations of adenosine deaminase (ADA), interferon-gamma, C-reactive protein (CRP), carcinoembryonic antigen, interleukin-6, tumor necrosis factor-alpha, and vascular endothelial growth factor in pleural fluid.
- Utilized receiver operating characteristic (ROC) curve analysis, multinomial logit modeling, and canonical variate analysis for group discrimination.
- Analyzed pleural fluid samples from 45 patients with malignant, 15 with parapneumonic, and 12 with tuberculous pleural effusion.
Main Results:
- The combined analysis of the seven biomarkers successfully discriminated between the three pleural effusion groups.
- Adenosine deaminase (ADA) and C-reactive protein (CRP) emerged as the most significant parameters for differentiation.
- Specific ADA and CRP concentration thresholds were identified to predict tuberculous (>45 U.L⁻¹ ADA, <4 mg.dL⁻¹ CRP), parapneumonic (<40 U.L⁻¹ ADA, >6 mg.dL⁻¹ CRP), and malignant (<4 mg.dL⁻¹ CRP) pleural effusion.
Conclusions:
- The combination of adenosine deaminase (ADA) and C-reactive protein (CRP) levels shows significant potential for discriminating between malignant, tuberculous, and parapneumonic exudative pleural effusions.
- These two biomarkers may offer a sufficient and reliable method for differentiating common causes of pleural effusion.
- Further validation of ADA and CRP as standalone or combined diagnostic markers for pleural effusion is warranted.
Related Concept Videos
01:25Pleural Effusion I: Introduction
Pleural effusion is an abnormal fluid accumulation in the pleural cavity, a narrow space between the lungs and the chest wall. It is not a disease per se but rather a symptom or indication of an underlying disease. In normal circumstances, this space contains a small amount of fluid (5 to 15 mL), a lubricant facilitating the non-frictional movement of the pleural surfaces.
There are two main types of pleural effusion: transudative and exudative. They are differentiated using Light's criteria,...
There are two main types of pleural effusion: transudative and exudative. They are differentiated using Light's criteria,...
01:28Pleural Effusion II: Symptoms and Management
Pleural Effusion Overview
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations: