A Young Non-Smoker with High ADA Pleural Effusion. It’s Not Always Tuberculosis

Chawla, Gopal; Kansal, Amrit Pal; Deokar, Kunal

doi:10.5603/arm.a2020.0144

Cited by 1 publication

(2 citation statements)

References 3 publications

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“…Different cut-off levels have been described [61], which can be affected by the commercial kit used, and patient factors (age [62,63] or comorbid illnesses [41,64,65]). Raised pleural fluid ADA levels can be found in non-TBP conditions, including occasional cancers, rheumatological conditions and many cases of pleural infection [35][36][37]66]. Bacterial empyema often generates very high ADA levels (e.g.…”

Section: Pleural Fluid Biomarkersmentioning

confidence: 99%

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Tuberculous pleuritis: clinical presentations and diagnostic challenges

Chan,

Lee

2024

Current Opinion in Pulmonary Medicine

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Purpose of review Tuberculous pleuritis (TBP) is one of the most common types of extrapulmonary tuberculosis. We highlight the latest epidemiology of TBP, the heterogeneity of its presentation and the performance of different diagnostic strategies. Recent findings There are differential trends in the incidences of TBP worldwide. Its incidence increased in China but decreased in the United States in the past decade. The presentation of TBP is heterogeneous regarding clinical symptoms, radiological findings and pleural fluid analysis results. Conventional microbiological tests have low sensitivities to diagnose TBP. Recent research focused on various diagnostic tools with better yield. The sensitivity of nucleic acid amplification tests (NAAT) in pleural fluid, including the latest generation of PCR and sequencing-based techniques for detecting tuberculosis, remains suboptimal. Various pleural fluid biomarkers have been explored, but there is a lack of consensus on their clinical utility and cutoff levels. Summary The heterogeneity of clinical presentation poses obstacles to diagnosing TBP. Further development of diagnostic tools, including more robust NAAT and biomarkers with additional validation, is needed before incorporation into routine clinical practice.

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Section: Pleural Fluid Biomarkersmentioning

confidence: 99%

“…Other pleural diseases (e.g. mesothelioma, lung cancer, lymphoma, immunoglobulin G4-related pleurisy) may mimic TBP due to shared pleural fluid analysis profile [27,[35][36][37].…”

Section: Pleural Fluid Analysismentioning

confidence: 99%