Are Pleural Fluid Parameters Related to the Development of Residual Pleural Thickening in Tuberculosis?

Pablo, Alicia de; Villena, Victoria; Echave-Sustaeta, José; Encuentra, A. López

doi:10.1378/chest.112.5.1293

Cited by 76 publications

(67 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…High levels of pleural fluid TNF-α, and low levels of glucose and pH (the latter observed in our patient) have been correlated with the subsequent development of pleural fibrosis in treated patients (19). TNF-α has been shown to cause a significant increase in proliferation and collagen production (mainly type 1) by rat pleural mesothelial cells in vitro (20).…”

Section: Discussionsupporting

confidence: 62%

Medical versus Surgical Treatment of a Primary Tuberculous Pleural Peel

Long

Fanning²,

McNamee³

et al. 2001

Canadian Respiratory Journal

View full text Add to dashboard Cite

The role and timing of surgical decortication in the management of a primary tuberculous pleural peel remains controversial. The present report describes the case of a young man with an extensive primary tuberculous pleural peel that responded dramatically to medical therapy. A serious attempt at surgical decortication three weeks into antituberculous drug therapy may have removed some compressive aspects of the peel, facilitating lung expansion. However, it had almost no measurable impact on the size of peel and was technically very difficult. Response to treatment was measured anatomically (computed tomography scans) and physiologically (pulmonary function tests).

show abstract

Section: Discussionsupporting

confidence: 62%

Medical versus Surgical Treatment of a Primary Tuberculous Pleural Peel

Long

Fanning²,

McNamee³

et al. 2001

Canadian Respiratory Journal

View full text Add to dashboard Cite

show abstract

“…LEE et al [13] reported 10%, SOLER et al [14] reported 72% and DE PABLO et al [7] and BARBAS et al [8] reported intermediate values of 43% and 52%, respectively. These variations can be attributed to the lack of a uniform concept for RPT.…”

Section: Discussionmentioning

confidence: 99%

“…Delay in implementing proper therapy for these effusions is responsible for much of the morbidity, which can be substantial. This delay can lead to characteristic changes in the pleural space, including loculations and pleural thickening [6].Previous studies have assessed what features predict pleural thickening in tuberculous pleural effusions [7,8], however only one study has retrospectively analysed predictive factors for the development of residual pleural thickening (RPT) in parapneumonic pleural effusions (PPE) [9]. Moreover, there are no studies addressing if RPT is associated with long-term functional consequences in this group of patients.…”

mentioning

confidence: 99%

“…Previous studies have assessed what features predict pleural thickening in tuberculous pleural effusions [7,8], however only one study has retrospectively analysed predictive factors for the development of residual pleural thickening (RPT) in parapneumonic pleural effusions (PPE) [9]. Moreover, there are no studies addressing if RPT is associated with long-term functional consequences in this group of patients.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Prognostic features of residual pleural thickening in parapneumonic pleural effusions

Castro¹,

Díaz²,

Pérez-Rodríguez³

et al. 2003

Eur Respir J

View full text Add to dashboard Cite

The objective of the study was the identification of predictive factors for the development of residual pleural thickening (RPT) in patients with parapneumonic effusion.The design of the prospective study involved investigating patients with parapneumonic pleural effusions diagnosed between March 1991 and December 2000 in the respiratory department of Hospital Ramón y Cajal (Madrid, Spain) which is a 1,500 tertiary-care hospital.The clinical and radiological characteristics and measurements of microbiological and biochemical variables in the pleural fluid taken from the patients were studied. RPT was defined in a posteroanterior chest radiograph as pleural thickening of o10 mm measured at the lateral chest wall at the level of an imaginary line, tangent to the diaphragmatic dome.A total of 48 of the 348 patients studied (13.79%) were found to have RPT. Among the factors studied, only presence of pus in the pleural space, Fine classes IV and V, temperature o38uC and delayed resolution of pleural effusions after diagnosis (w15 days) were independently associated with the risk of RPT.This study showed that significant residual pleural thickening was not a common complication of parapneumonic pleural effusions. There are certain risk factors for the development of residual pleural thickening. However, this complication was not associated with long-term functional repercussions in the series of patients involved in this study. Despite the advent of potent antibiotics, bacterial pneumonia still results in morbidity and mortality. The annual incidence of bacterial pneumonia is estimated to range from 1.8-8 cases per 1,000, withy20% requiring hospitalisation [1]. It has been reported that 57% of hospitalised patients with bacterial pneumonia have an accompanying pleural effusion [2][3][4]. The morbidity and mortality rates in patients with pneumonia and pleural effusions are higher than in patients with pneumonia alone [5]. Most pleural effusions associated with pneumonia resolve without any specific therapy directed toward the pleural fluid [2], however y10% require operative intervention for their resolution. Delay in implementing proper therapy for these effusions is responsible for much of the morbidity, which can be substantial. This delay can lead to characteristic changes in the pleural space, including loculations and pleural thickening [6].Previous studies have assessed what features predict pleural thickening in tuberculous pleural effusions [7,8], however only one study has retrospectively analysed predictive factors for the development of residual pleural thickening (RPT) in parapneumonic pleural effusions (PPE) [9]. Moreover, there are no studies addressing if RPT is associated with long-term functional consequences in this group of patients.The purpose of the present study was to prospectively evaluate the prognostic features of RPT and its functional repercussions in a consecutive series of patients with PPE. The authors therefore hypothesise that RPT is an uncommon complication of PPE and is no...

show abstract

“…Residual pleural thickening still occurs in most patients with tuberculosis despite advances in the treatment of tuberculosis [2][3][4][5]. To date, the relationship between pleural thickening and biochemical, biological and microbiological parameters of the pleural fluid have been studied.…”

Section: Introductionmentioning

confidence: 99%

The relation of the pleural thickening in tuberculosis pleurisy with the activity of adenosine deaminase

Uskul

Türker

Ulman

et al. 2005

Monaldi Arch Chest Dis

View full text Add to dashboard Cite

Selvi, A. Kant, S. Arslan, M. Ozgel. Background: Residual pleural thickening (RPT) still occurs in most patients with tuberculosis pleurisy despite advances in the treatment of tuberculosis. The aim of this study was to evaluate the significance of RPT in tuberculosis pleurisy with the patients clinical findings, biochemical and microbiological properties of pleural effusion and with the total adenosine deaminase (ADA) and isoenzymes levels. Methods: 121 tuberculosis pleurisy patients were evaluated retrospectively. According to posteroanterior chest x-rays, the 63 (52%) cases with the thickness 2 mm or more in lower lateral hemithorax were grouped as I and the 58 (48%) cases without pleural thickness were grouped as II. The amount of pleural effusion was classified into small, medium or massive according to their chest x-rays. In both groups; sex, age, symptoms score, bacteriological and biochemical tests and ADA levels were recorded. Results: 81 (67%) male and 40 (33%) female, overall 121 patients were enrolled into the study. RPT was found higher in males (p=0.014) and the increase ran parallel with the amount of cigarette smoking (p=0.014). RPT was found to be lower in small effusions (p=0.001). The group with RPT, the serum albumin was found lower (p=0.002), pleural fluid total protein (p=0.047) and the ratio of pleural fluid protein to serum protein (p=0.002) were found higher. In group I, total ADA: 69.5±38.9 IU/L and ADA2: 41.3±31.6 IU/L were higher than the cases without RPT (p=0.032, p=0.017, respectively). Conclusions: We suggest that the immunological mechanisms are effective in the development of pleural thickening.

show abstract

Are Pleural Fluid Parameters Related to the Development of Residual Pleural Thickening in Tuberculosis?

Cited by 76 publications

References 13 publications

Medical versus Surgical Treatment of a Primary Tuberculous Pleural Peel

Medical versus Surgical Treatment of a Primary Tuberculous Pleural Peel

Prognostic features of residual pleural thickening in parapneumonic pleural effusions

The relation of the pleural thickening in tuberculosis pleurisy with the activity of adenosine deaminase

Contact Info

Product

Resources

About