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Are pleural fluid parameters related to the development of residual pleural thickening in tuberculosis?
A de Pablo1, V Villena, J Echave-Sustaeta
1Respiratory Disease Service, Hospital Universitario 12 de Octubre, Madrid, Spain.
Study Objective:
Identification of predictive factors for the development of residual pleural thickening (RPT).
Design:
Retrospective study.
Location:
A 1,500-bed tertiary hospital.
Patients:
Patients with pleural tuberculosis diagnosed between December 1991 and February 1995 in our Respiratory Disease Service.
Interventions:
The clinical and radiologic characteristics, and measurements of microbiological and biochemical parameters and markers in pleural fluid were studied. RPT was defined in a posteroanterior chest radiograph as a pleural space of >2 mm measured in the lower lateral chest at the level of an imaginary line intersecting the diaphragmatic dome.
Measurements And Results:
In 56 patients studied, 11 (19.6%) had RPT 10 mm and 24 (42.8%) had RPT >2 mm. The pleural fluid of patients with RPT 10 mm had a significantly lower glucose concentration and pH and higher lysozyme and tumor necrosis factor-alpha levels than the other patients. The pleural fluid of patients with RPT >2 mm showed no significant differences.
Conclusions:
The development of RPT 10 mm was related to higher concentrations of lysozyme and tumor necrosis factor-alpha and lower glucose concentration and pH in pleural fluid compared with development of lower measurements of RPT.