Etiology and clinical profile of pleural effusion

Maikap, Malay Kumar; Dhua, Aparup; Maitra, Malay Kumar

doi:10.5455/ijmsph.2018.0101931012018

Cited by 7 publications

(10 citation statements)

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“…One previous study found majority of their cases between 21 and 40 year of age [18] another study found majority of their cases (29.6%) below 20 years of age [19]. In the present study revealed that pleural effusions were predominantly observed in the right side (61.33%) which corroborates with a few previous studies [13,17,20].…”

Section: Discussionsupporting

confidence: 91%

“…The male preponderance is similar among tuberculosis and MPE group also. Sharma SK et [16] al and Maikap M K et al [13] also found similar male majority in their previous studies. In the present study, the patients with pleural effusion were found in all age groups ranging from 11 years boy as the youngest subject and 71 years aged male was the eldest and patients aged between 31 and 40 represent the largest group (29.34%).…”

Section: Discussionsupporting

confidence: 65%

“…Tuberculosis was also the leading cause of pleural effusion ina study conducted by Maikap MK [13], while world wide CCF is the most common cause of pleural effusion [14]. But a study conducted in respiratory intensive care set up by Chinchkar N J and co workers found malignancy to be the most frequent cause of pleural effusion [15].…”

Section: Discussionmentioning

confidence: 99%

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A clinicopathological study of pleural effusion with special reference to malignant aetiology in a tertiary care hospital in West Bengal

et al. 2019

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Background: Pleural effusion has varied aetiological factors. It constitutes one of the major causes of morbidity in India as well in other parts of world. Because of the various aetiologies that can cause pleural effusion, itoften present a diagnostic problem, even after extensive investigations. Objective: In this study, authors aimed to identify the common aetiologies causing pleural effusion and their clinical profile in a tertiary care hospital. Materials and Methods: A hospital based cross-sectional study is conducted over a period of one year in tertiary care hospital in West Bengal. 150 patients of pleural effusion above 10 yrs of age were studied. Clinico-pathological, radiological, hematological and biochemical parameters were documented. Results: The most common cause pleural effusion in this study was tuberculosis (64.67%), followed by malignancy (14.67%), parapneumonic effusion (7.33%), cardiac failure (5.33%) and other minor causes. It was commonly seen in male (70%). The occurrence of tubercular pleural effusion was maximum in the age group 31-40 years. Right-sided effusions were more common. Pleural fluid cytology and adenosine deaminase played a pivotal role in the diagnosis of tubercular pleural effusion. Conclusion: The present study highlights tuberculosis as the common causative factor for pleural effusion, labels lung carcinoma as the most common cause of malignant pleural effusion, and defines the clinico-pathological, biochemical and imaging characteristics of different aetiologies of pleural effusion.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 65%

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A clinicopathological study of pleural effusion with special reference to malignant aetiology in a tertiary care hospital in West Bengal

et al. 2019

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“…For example, in the Indian subcontinent and in African nations, the most common cause for pleural effusion is tuberculosis, understandably due to higher prevalence of tuberculosis in these populations. [28][29][30] In our study we observed an infective cause, such as pneumonia (parapneumonic) or other infections or abscess in the liver/abdominal/pancreatic/ gallbladder, were judged to be the most common cause for plural effusion, more so among the indigenous cohort, However, positive microbiology yield of pleural fluid was very low. The other most common cause for pleural effusion was observed to be secondary to renal disease (fluid overload) among indigenous patients.…”

Section: Discussionmentioning

confidence: 84%

“…However, the aetiology might differ depending on the geography and the pattern and prevalence of disease burden in the local population. For example, in the Indian sub‐continent and in African nations, the most common cause for pleural effusion is tuberculosis, understandably due to higher prevalence of tuberculosis in these populations 28–30 . In our study we observed an infective cause, such as pneumonia (parapneumonic) or other infections or abscess in the liver/abdominal/pancreatic/gallbladder, were judged to be the most common cause for plural effusion, more so among the indigenous cohort, However, positive microbiology yield of pleural fluid was very low.…”

Section: Discussionmentioning

confidence: 99%

Comparison of clinical manifestation among Australian Indigenous and non‐indigenous patients presenting with pleural effusion

Heraganahally

Silva

Howarth

et al. 2022

Internal Medicine Journal

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Background There is sparse evidence in the literature in relation to the nature and causes of pleural effusion among Australian Indigenous population. Aim To investigate the clinical and demographic characteristics of adult indigenous patients presenting with pleural effusion in the Northern Territory of Australia. Methods In this retrospective study, indigenous and non‐indigenous adults diagnosed to have pleural effusion over a 2‐year study period were included for comparative analysis. Results Of the 314 patients, 205 (65%) were non‐indigenous and 52% were male. In comparison with non‐indigenous patients, the indigenous patients were younger (50 years (interquartile range (IQR) 39–60) vs 63 years (IQR 52–72); P < 0.001), female (61% vs 41%; P = 0.001), had a higher prevalence of renal and cardiovascular disease and tended to have exudative effusion (93% vs 76%; P = 0.032). Infections were judged to be the most common cause of effusion in both groups, more so among the indigenous cohort. Effusion secondary to renal disease was higher (13% vs 1%; P < 0.001) among Australian Indigenous patients, but in contrast, malignant effusions were higher (13% vs 4%; P = 0.004) among non‐indigenous patients. Length of hospital stay was longer for indigenous patients (P = 0.001), and a greater proportion received renal dialysis (13% vs 1%; P < 0.001). Intensive care unit admission rates were higher with infective aetiology of pleural effusion (82% vs 53% indigenous and 44% vs 39% non‐indigenous respectively). Re‐presentations to hospital were higher among indigenous patients (46% vs 33%; P = 0.046) and were associated with renal and cardiac disease and malignancy in non‐indigenous patients. Conclusion There are significant differences in the way pleural effusion manifests among Australian Indigenous patients. Understanding these differences might facilitate approaches to management and to implementation of strategies to reduce morbidity and mortality in this population.

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The Use of “Cancer Ratio” in Differentiating Malignant and Tuberculous Pleural Effusions: Protocol for a Prospective Observational Study (Preprint)

Chalamalasetty,

Acharya,

Antony

et al. 2024

Preprint

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BACKGROUND Differentiating between tuberculosis and malignancy as the cause of an exudative lymphocyte predominant pleural effusion is difficult due to similarities in the cellular and biochemical characteristics of the pleural fluid in both conditions. Microbiological tests in tubercular pleural effusions have a poor diagnostic yield, and the long turnaround time for results prevents an early diagnosis. The diagnosis of malignant pleural effusion (MPE) is hampered by a variable yield of pleural fluid cytology and closed pleural biopsy and the fact that thoracoscopy may not be readily available or feasible in each patient. A key gap in the existing knowledge is the performance of the serum lactate dehydrogenase to pleural adenosine deaminase ratio (ie, “cancer ratio”; CR) in differentiating between tuberculous and MPE in a high tuberculosis prevalence country like India, although its use has been well established in Western literature. The CR may find a practical application in the community health care settings in low-income countries without ready access to biopsy. OBJECTIVE This study aimed to evaluate the CR as a test to differentiate tubercular and malignant etiology in patients with an exudative lymphocyte predominant pleural effusion. Secondary objectives to be assessed include a comparison of CR to pleural fluid carcinoembryonic antigen in MPE and the association of histologic type of lung carcinoma to the CR positivity. METHODS This hospital-based, prospective, observational study will include patients admitted with pleural effusion whose pleural fluid reports indicate a lymphocyte-predominant exudate. The ability of the CR to discriminate between tuberculous and MPE will be evaluated as a primary objective of this study. The performance of CR and pleural fluid carcinoembryonic antigen in the diagnosis of MPE will be compared using the receiver operating characteristics and area under the curve for both tests as a secondary objective. The association between a positive CR and histologic type of lung cancer will be analyzed as well. RESULTS Data collection began in June 2022. As of March 24, 2024, we have recruited 22 patients. Outcomes of the study are expected at the end of 2024. CONCLUSIONS The results of this study will provide an objective basis for the use of CR in differentiating between tuberculosis and malignancy as the cause of an exudative lymphocyte predominant pleural effusion. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/56592

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Etiology and clinical profile of pleural effusion

Cited by 7 publications

References 0 publications

A clinicopathological study of pleural effusion with special reference to malignant aetiology in a tertiary care hospital in West Bengal

A clinicopathological study of pleural effusion with special reference to malignant aetiology in a tertiary care hospital in West Bengal

Comparison of clinical manifestation among Australian Indigenous and non‐indigenous patients presenting with pleural effusion

The Use of “Cancer Ratio” in Differentiating Malignant and Tuberculous Pleural Effusions: Protocol for a Prospective Observational Study (Preprint)

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