A study to assess the cholesterol levels in pleural fluid and its role in differentiate between exudative and transudate pleural effusion

Abstract

The pathophysiology of the transudate pleural effusion occurs when the systemic factors are involved in the formation and absorption of plural effusion, where the source of pleural fluid is originating from Lung, Peritoneal or Pleural Cavity. The origin of exudative pleural fluid effusion is when capillaries or the pleural surfaces where the fluid originates gets altered. Hence when we the pleural fluid is found to be transudate further diagnostic evaluation is not required and treat the systemic disease affecting it and if the fluid is exudate we need to investigate further to find out the cause of effusion. To assess the role of pleural fluid cholesterol in differentiating exudative and transudative pleural effusion. : The present cross sectional study was conducted by the Department of Chest and Respiratory Medicine at Chamarajanagara Institute of Medical Sciences from March 2019 to December 2019. A total of 100 cases of clinically confirmed cases of pleural effusion cases were selected for the purpose of the study. Based on the Light’s Criteria the Pleural Fluid was analyzed and 94% of them were classified as exudates and 6% of them to be transudates and Pleural fluid cholesterol of more than 45mg/dl 74% of them were exudates and 26% of them were transudates. In the present study based on final diagnosis out of 74 subjects who were classified as exudates, 72 subjects were classified as exudates and misclassified 2 cases as transudate. Lights Criteria diagnosed only 4 cases as transudate pleural fluid among the 26 cases of transudate pleural fluid based on final diagnosis Light‘s criteria is the most accepted criteria for differentiating between exudates and transudate in pleural effusion. By the Present study we could conclude that the estimation of Pleural Cholesterol Level has good sensitivity, Positive Predictive Value than lights criteria in diagnosing exudative and transudate Pleural Fluid.