A study of correlation of pleural fluid ldh, protein, cholesterol, bilirubin and cells as an aid to clinical diagnosis and management of pleural effusion

Abstract

Background&Method: This study was conducted with an aim toassess the usefulness of pleural
fluid LDH, PROTEIN, CHOLESTEROL, BILIRUBIN and CELLS in diagnosis and
differentiating transudative and exudative pleural effusion patient.All patients between >18 years
of age admitted in Chest ward of Index Medical College, Indore with diagnosis of a PLEURAL
EFFUSION. Study was be conducted on 60 patients from the Department of TB and CHEST at
Index Medical College, Hospital & Research centre Indore and all the tests was be perform with
due permission from the Institutional Ethical Committee and informed consent from the subjects
or their legal relatives. Subjects were included on the basis of their diagnosis of PLEURAL
EFFUSION as per Extended Lights criteria.
Result:According to Lights Criteria the mean pleural sugar is 86.29±48.88 in exudates and
116±42.76 in transudate, although it was not statistically significant. The mean protein value is
4.73±1.11 in exudates and 2±0.81 in transudate and this difference between the mean protein
values was statistically significant. Mean pleural LDH is 896±867 in exudates and 189±60 in
transudate, although this difference between the mean values was not statistically significant.
The mean cholesterol value is 78.14±38.20 in exudates and 31.75±21.54 in transudate and this
difference between the mean protein values was statistically significant. The mean ADA value is
56.96±28.58 in exudates and 19.75±13.52 in transudate and this difference between the mean
protein values was statistically significant.
Conclusion:In pulmonary medicine, pleural effusion diagnosis is still a developing field. With
the increased prevalence of pleural disease, multidisciplinary initiatives to improve diagnosis
accuracy while remaining cost-effective are required. Pleural fluid cholesterol criteria
(cholesterol >60 mg/dl – exudate; cholesterol <60 mg/dl – transudate) are shown to be an
effective tool for separating pleural effusions in this investigation. As a result, it is suggested that
using pleural fluid cholesterol to distinguish exudate from transudate is preferable to using Light's criteria, with the added benefit of not having to collect a blood sample at the same time,
especially in countries like India where financial and technical constraints are severe.