Abstract

Pleural effusion may occur in different infections or as a complication of pulmonary disease, malignant disease. Exudative pleural effusion results from local or systemic disease that directly injure the pleural surface. To know intrapleural pathology, correct diagnosis of pleural effusion is essential. For this many parameters have been proposed for segregation of exudates from transudates. Cholinesterase level in pleural effusion of diverse etiologies helps to differentiate between transudates and exudates. Methods The study was conducted in the Department of General Medicine, SCB Medical College & Hospital, Cuttack during the period from June 2019 to September 2020. 100 consecutive patients admitted were included in the study group. Thoracocentesis was done in all patients and samples were sent for biochemical, microbiological and cytological tests. Cholinesterase estimation was done by photometer 5010V5+. Final diagnosis was done by clinical, biochemical, cytological and microbiological results. Results Out of 100 cases, 78 cases were male and 22 cases were females, with male: female ratio 3.4:1. Tubercular effusion was the most common cause followed by congestive cardiac failure. Fever was the most common clinical presentation (62%). The mean total cell count was more in exudate (2911.820+/1511.48). The pleural fluid cholinesterase level of 943.5U/L was 96% sensitive and 93% specificity. Conclusion Pleural fluid cholinesterase level of 943.5U/dl gives a more reasonable sensitivity and specificity (96% sensitive and 93% specific) to differentiate from exudates and transudates , while that of 981U/dl is more specific(92.6% sensitive and >99% specific ) and can be taken as taken as gold standard as specificity approaches 100%. The result of present study revealed that pleural fluid cholinesterase is the most accurate parameter for the differentiation of transudates and exudates.

Description

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