Diagnostic significance of cholesterol in pleural effusion.

Yeo, Dong Seung; Lee, Dong Il; Lee, Soo Keol; Moon, Chang Hyung; Park, Soon Kew; Shin, Young Kee

doi:1992.39.3.248

Tuberc Respir Dis > Volume 39(3); 1992 > Article

Original Article

Tuberculosis and Respiratory Diseases 1992;39(3):248-254.
DOI: https://doi.org/10.4046/trd.1992.39.3.248 Published online June 1, 1992.

Diagnostic significance of cholesterol in pleural effusion.

Dong Seung Yeo, Dong Il Lee, Soo Keol Lee, Chang Hyung Moon, Soon Kew Park, Young Kee Shin

Department of Internal Medicine, Pusan University College of Medicine, Seoul, Korea

Abstract

Background
Pleural effusion is one of the most common clinical problems in pulmonology because of high prevalence of pulmonary tuberculosis and bronchogenic carcinoma in Korea. The differential diagnosis between pleural transudate and exudate is very important, but it is very difficult in some cases.
Methods
In order to assess the clinical usefulness of cholesterol levels for the differential diagnosis of pleural transudate and exudate, we measured pleural fluid cholesterol levels by enzymatic method in 45 patients who were admitted due to pleural effusion.
Results
The mean cholesterol level of transudate was 33.1 ± 12.9 mg%, tuberculous exudate was 97.3 ± 28.2 mg% and malignant exudate was 97.3 ± 28.2mg%. When the cut-off value of pleural cholesterol level was 60 mg% , one case (6.7%) of tuberculous exudate and two cases (13.3%) of malignant exudate were incorrectly classified, but all cases of transudate were classified correctly. When the cut.off value of pleural/serum cholesterol ratio was 0.3, one case (6.7%) of transudate and two cases (13.3%) of malignant exudate were incorrectly classified, but all cases of tuberculous exudate were classified correctly. When the cut.off value of pleural cholesterol level to differentiate pleural transudate from exudate was 60 mg%, sensitivity was 90% and specificity was 100%. When the cut.off value of pleural/serum cholesterol level to differentiate pleural transudate form exuidate was 0.3, sensitivity was 93% and specifiity was 93%.
Conclusions
From the above results, it can be concluded that measurement of pleural fluid cholesterol levels is useful for the differential diagnosis between pleural transudate and exudate.

Key Words: Pleural effusion, Transudate, Exudate, Cholesterol

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