Pleural Procalcitonin Research Articles

Diagnostic value of procalcitonin in pleural effusion

Background A wide range of diseases can cause pleural effusion. Its diagnosis and management remain a clinical challenge, bearing a significant cost to both patients and health care system. Objective To assess the role of procalcitonin (PCT) level in discriminating transudative from exudative pleural effusion and in differentiation between some types of exudative effusion. Patients and methods A total of 45 patients having pleural effusion were enrolled in this study and were divided into two groups. Group I included 15 patients having transudative pleural effusion. Group II included 30 patients having exudative pleural effusion. This group was subdivided into group IIa, which included 10 patients having tuberculous effusion; group IIb, which included 10 patients having malignant effusion; and group IIc, which included 10 patients having parapneumonic effusion. Quantitative measurement of PCT in both serum and pleural fluid was done using enzyme-linked immunosorbent assay. Results Exudative effusion had significantly higher levels of serum and pleural PCT when compared with transudative one. Regarding serum and pleural PCT levels in different types of exudative effusion, highest level was in parapneumonic followed by malignant, and then tuberculous pleural effusion, and the difference between them was statistically significant. Conclusion Measurement of both serum and pleural PCT may be used to differentiate transudative from exudative type of pleural effusion and may be used also to discriminate parapneumonic from other causes of exudative pleural effusion.

Diagnostic value of procalcitonin and C-reactive protein in differentiation between some benign and malignant pleural effusions

Pleural effusion is relatively common clinical condition that requires differential diagnosis. It is defined as collection of fluid in pleural space. Pleural effusion is often diagnostic dilemma for the physician.The aim of the study was to assess the procalcitonin (PCT) and C-reactive protein (CRP) levels in serum and pleural fluid to evaluate their usefulness in the differentiation among benign and malignant pleural effusions.This study was conducted in Chest Department, Tanta University Hospital, it included 54 adult patients with pleural effusions of different etiologies, 8 transudative effusion, 14 para-pneumonic effusion, 14 tuberculous effusion and 18 malignant effusion. We measured serum and pleural procalcitonin and C-reactive protein by ELISA.The mean serum and pleural fluid procalcitonin (PCT) levels in parapneumonic effusions were significantly higher compared with transudative, tuberculous and malignant pleural effusions p<0.05. A significant positive correlation between serum and pleural fluid PCT levels was observed in the studied groups. The mean serum and pleural fluid CRP concentration were significantly lower in malignant and transudative pleural effusion than tuberculous and para-pneumonic effusion p<0.05.Significant positive correlation between serum and pleural fluid CRP levels was observed in the studied groups. Procalcitonin levels in serum and pleural effusion were significantly lower in malignant effusion compared to para-pneumonic pleural effusion and CRP levels were significantly lower compared to other types of exudative pleural effusion.

Diagnostic Value of Procalcitonin and C-Reactive Protein in Differentiation of Pleural Effusions

Background: Malignancies are a common and important causes of exudative pleural effusions. Several tumor markers have been studied because the pleural fluid cytology and pleural biopsy specimens do not provide a diagnosis in a high percentage of malignant effusions. In an attempt to overcome this limitation, procalcitonin and C-reactive protein (CRP) in pleural effusions and serum, which are known to be inflammation markers, were measured to determine if they can differentiate an exudate from trasndate as well as the diverse causes of exudative pleural effusion. Methods: 178 consecutive patients with pleural effusion (malignant 57, tuberculous 51, parapneumonic 31, empyema 5, miscellaneous benign 7, transudative 27)were studied prospectively. The standard parameters of pleural effusion and measured serum and pleural procalcitonin were examined using in immunoluminometric assay. The level of CRP in serum and pleural fluid was determined by turbidimetric immunoassay. Results: The pleural procalcitonin levels in the exudate were significantly higher than those in the transudate, and , respectively (p=0.007). The pleural CRP levels were significantly higher in the exudate than the transudate, and , respectively (p and , respectively (p=0.032). The pleural CRP levels were significantly higher in the benign effusion than in the malignant effusion, and , respectively (p and , respectively (p=0.008). Conclusion: Measuring the level of procalcitonin and CRP in the pleural fluid is helpful for differentiating between transudates and exudates. In addition, it is useful for differentiating between benign and malignant pleural effusions.