We have located links that may give you full text access.
Use of pleural fluid C-reactive protein in laboratory diagnosis of pleural effusions.
European Journal of Medicine 1992 July
OBJECTIVES: C-reactive protein (CRP) which is synthetized by hepatocytes is an acute phase protein and its serum level increases within 6-9 hours after infection or tissue damage. We investigated its usefulness as a marker of bacterial infection in patients with pleural effusion.
METHODS: We studied the usefulness of pleural fluid C-reactive protein measurement in a population of 72 patients with pleural effusion, by means of an immunoturbidimetric method (Hitachi 717, Boheringer Mannheim). A comparison of serum and pleural effusion C-reactive protein levels in different subgroups of patients with effusion was made.
RESULTS: According to preset diagnostic criteria, 19 patient effusions were classified as transudates and the mean (+/- 5 D) pleural fluid CRP [5.3 (+/- 7.8) mg per liter, p < 0.001] were significantly lower than those in the exudate effusions group. Among the 53 patients with exudate effusion, eight were caused by neoplastic disease and the pleural fluid CRP mean (29.3 +/- 16.1 mg per liter, p < 0.001) were significantly lower than those in exudates from parapneumonic effusions (122.7 +/- 48.0 mg per liter, p < 0.001) and than those in the exudates from patients with effusion associated with tuberculosis (67.8 +/- 32.1 mg per liter, p < 0.001). Moreover, all but two transudates had a C-reactive protein lower than 10 mg/L, whereas only two exudates with tuberculosis origin had a C-reactive protein value lower than 10 mg/L, instead all pleural-fluid C-reactive protein from exudates with pneumonia were greater than 10 mg/L. We had found a correlation between the pleural and serum C-reactive protein (r = 0.6884, p < 0.0001). And transudates tended to have lower ratios of pleural to serum CRP (0.26) than exudates (0.55), and malignant effusions had lower ratios (0.37) than pneumonic and tuberculous effusions (0.52, 0.58).
CONCLUSIONS: Pleural fluid CRP > 10 mg per liter had good sensitivity (82%), specificity (87.5%) and predictive value of positivity (95.5%) in the diagnosis of exudate effusions and higher CRP-levels may prove to be a practical, accurate and rapid method for differentiating pneumonic effusions and effusions associated with tuberculosis from others. It can be considered that quantitative immunoturbidimetric assay of pleural-fluid C-reactive protein will be a useful diagnostic tool to differentiate pleural effusions with bacterial origin from others.
METHODS: We studied the usefulness of pleural fluid C-reactive protein measurement in a population of 72 patients with pleural effusion, by means of an immunoturbidimetric method (Hitachi 717, Boheringer Mannheim). A comparison of serum and pleural effusion C-reactive protein levels in different subgroups of patients with effusion was made.
RESULTS: According to preset diagnostic criteria, 19 patient effusions were classified as transudates and the mean (+/- 5 D) pleural fluid CRP [5.3 (+/- 7.8) mg per liter, p < 0.001] were significantly lower than those in the exudate effusions group. Among the 53 patients with exudate effusion, eight were caused by neoplastic disease and the pleural fluid CRP mean (29.3 +/- 16.1 mg per liter, p < 0.001) were significantly lower than those in exudates from parapneumonic effusions (122.7 +/- 48.0 mg per liter, p < 0.001) and than those in the exudates from patients with effusion associated with tuberculosis (67.8 +/- 32.1 mg per liter, p < 0.001). Moreover, all but two transudates had a C-reactive protein lower than 10 mg/L, whereas only two exudates with tuberculosis origin had a C-reactive protein value lower than 10 mg/L, instead all pleural-fluid C-reactive protein from exudates with pneumonia were greater than 10 mg/L. We had found a correlation between the pleural and serum C-reactive protein (r = 0.6884, p < 0.0001). And transudates tended to have lower ratios of pleural to serum CRP (0.26) than exudates (0.55), and malignant effusions had lower ratios (0.37) than pneumonic and tuberculous effusions (0.52, 0.58).
CONCLUSIONS: Pleural fluid CRP > 10 mg per liter had good sensitivity (82%), specificity (87.5%) and predictive value of positivity (95.5%) in the diagnosis of exudate effusions and higher CRP-levels may prove to be a practical, accurate and rapid method for differentiating pneumonic effusions and effusions associated with tuberculosis from others. It can be considered that quantitative immunoturbidimetric assay of pleural-fluid C-reactive protein will be a useful diagnostic tool to differentiate pleural effusions with bacterial origin from others.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app