A COMPARATIVE STUDY BETWEEN PLEURAL FLUID CHOLESTEROLAND LIGHT'S CRITERIA FOR DIFFERENTIATION OF EXUDATIVE AND TRANSUDATIVE PLEURAL EFFUSION

Abstract

Introduction: Pleural effusion is one of the common clinical disorders encountered in the medical wards. In a patient with pleural effusion diagnosis can be arrived by history, clinical examination and radiological techniques. Pleural effusion is collection of uid in intrapleural space and manifestation of several diseases, both pulmonary and extra pulmonary, often isolated 1. Based on the underlying pathological abnormality and mechanism of formation, effusion may be either transudative or exudative. To nd out etiology, rst step is to differentiate whether the pleural effusion is of exudate or transudate type. Etiology of pleural effusions differ in different parts of the world. Aims And Objectives: The study is conducted to compare between pleural uid cholesterol and Light's criteria for differentiation of transudative and exudative pleural effusion. The sensitivity and specicity of pleural uid cholesterol estimation as an independent biochemical marker in exudative pleural effusion. Methodology: The present work was conducted in the N.R.S. Medical College and Hospital Kolkata(Department of GENERAL MEDICINE ). Study was done from February 2018 to 1st May 2019 i.e., through one year and three month period. 70 patients both male and female Patients admitted in N.R.S MEDICALCOLLEGE with symptoms suggestive of pleural effusion. Result And Analysis: Our study showed that mean serum protein level in tuberculous effusion patients is 6.322 gm/dl. In Para pneumonic effusion cases mean serum protein level is 6.867 gm/dl. Mean serum Protein level in transudative effusion cases is 6.923 gm/dl. In patients with malignant effusion, the mean serum protein level is 6.492 gm. /dl. In empyema patients, mean serum protein level is Summary: Pleural effusion develops in a variety of illnesses. Based on the underlying pathology and mechanism of formation, effusions may be either transudates or exudates. Analysis of pleural effusion is an important diagnostic step to guide further investigations and treatment. Conclusion: Pleural uid cholesterol with a cut-off value of >55 mg/dL is better than Light's criteria in the differentiation of exudative pleural effusions. The sensitivity and specicity of differentiation can be improved by combining pleural uid protein with pleural uid cholesterol. Both these criteria are cost effective than the Light's criteria because it does not require a simultaneous blood sampling for differentiation. So in a country like India where there is maximum nancial constraints, it will be helpful for rural and urban poor patients. In resource-limited settings, pleural uid cholesterol can replace Light's criteria for classication of pleural effusion