The use of pleural fluid procalcitonin and C-reactive protein in the diagnosis of parapneumonic pleural effusions: a systemic review and meta-analysis

Zou, Ming-Xiang; Zhou, Rongrong; Wu, Wen-hsien; Zhang, Ning-Jie; Liu, Wenen; Fan, Xue‐Gong

doi:10.1016/j.ajem.2012.04.004

Cited by 32 publications

(20 citation statements)

References 29 publications

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“…The production of procalcitonin, unlike that of CRP, was reported to be elevated only in response to bacterial infection but not to noninfectious inflammation or nonbacterial infection 29. Accordingly, our results have shown that procalcitonin was significantly increased in serum of patients with cirrhosis related ascites but most markedly in culture-positive SBP with a high sensitivity and specificity for a cut off value of 0.61.…”

Section: Discussionsupporting

confidence: 44%

The Role of Serum Procalcitonin Levels in Predicting Ascitic Fluid Infection in Hospitalized Cirrhotic and Non-cirrhotic Patients

Çekın¹,

Çekın²,

Duman³

et al. 2013

Int. J. Med. Sci.

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Objective: To determine the role of serum procalcitonin levels in predicting ascites infection in hospitalized cirrhotic and non-cirrhotic patients.Methods: A total of 101 patients (mean age: 63.4±1.3, 66.3% were males) hospitalized due to cirrhosis (n=88) or malignancy related (n=13) ascites were included in this study. Spontaneous bacterial peritonitis (SBP, 19.8%), culture-negative SBP (38.6%), bacterascites (4.9%), sterile ascites (23.8%) and malign ascites (12.9%) groups were compared in terms of procalcitonin levels in predicting ascites infection. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of procalcitonin levels and predicting outcome of procalcitonin levels was compared with C-reactive protein (CRP).Results: Culture positivity was determined in 26.7% of overall population. Serum procalcitonin levels were determined to be significantly higher in patients with positive bacterial culture in ascitic fluid compared to patients without culture positivity (median (min-max): 4.1 (0.2-36.4) vs. 0.4 (0.04-15.8), p<0.001). Using ROC analysis, a serum procalcitonin level of <0.61 ng/mL in SBP (area under curve (AUC): 0.981, CI 95%: 0.000-1.000, p<0.001), <0.225 ng/mL in culture-negative SBP (AUC: 0.743, CI 95%: 0.619-0.867, p<0.001), <0.42 ng/mL in SBP and culture-negative SBP patients (AUC: 0.824, CI 95%: 0.732-0.916, p<0.001), and <1.12 ng/mL in bacterascites (AUC: 0.837, CI 95%: 0.000-1.000, p=0.019) were determined to accurately rule out the diagnosis of bacterial peritonitis. Predictive power of serum procalcitonin levels in SBP + culture-negative SBP group (AUCs: 0.824 vs 0.622, p=0.004, Fig 4), culture-positive SBP (AUCs: 0.981 vs 0.777, p=0.006, Fig 5) and (although less powerfull) in culture-negative SBP (AUCs: 0.743 vs 0.543, p=0.02, Fig 6) were found significantly higher than CRP.Conclusion: According to our findings determination of serum procalcitonin levels seems to provide satisfactory diagnostic accuracy in differentiating bacterial infections in hospitalized patients with liver cirrhosis related ascites.

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Section: Discussionsupporting

confidence: 44%

The Role of Serum Procalcitonin Levels in Predicting Ascitic Fluid Infection in Hospitalized Cirrhotic and Non-cirrhotic Patients

Çekın¹,

Çekın²,

Duman³

et al. 2013

Int. J. Med. Sci.

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“…Previous research reported that the specificity and sensitivity C-reactive protein for pleural effusions were higher than the specificity and sensitivity of procalcitonin. 15 Calprotectin, tumor necrosis factor alpha, and C-reactive protein were also shown to be useful in the diagnosis of exudative pleural effusions. 15,16 High levels of serum amyloid alpha were observed in the exudate of patients with PPEs but subsequently disappeared following the development of pleural thickening.…”

Section: Discussionmentioning

confidence: 99%

“…15 Calprotectin, tumor necrosis factor alpha, and C-reactive protein were also shown to be useful in the diagnosis of exudative pleural effusions. 15,16 High levels of serum amyloid alpha were observed in the exudate of patients with PPEs but subsequently disappeared following the development of pleural thickening. 17 The level of is- chemia-modified albumin was reported to be a marker in pleural effusions, with higher levels in transudative than exudative effusions.…”

Section: Discussionmentioning

confidence: 99%

What is the Diagnostic Value of Plasma Antioxidative/Oxidative Status in Parapneumonic Effusions in Children?

Aydinoğlu¹,

Cevik²,

Böleken³

et al. 2017

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ci iv ve e: : Pleural effusions are associated with high morbidity in children. Oxidative stress, which refers to an imbalance between oxidants and antioxidants, is associated with various diseases including lung diseases. The aim of this study was to investigate to the total oxidative status (TOS) and total antioxidative status (TAS) in differentiating exudates from transudates in children. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : In this cross-sectional study, data from patients who were hospitalized for parapneumonic effusions and underwent thoracentesis from October 2012 to December 2013 in the pediatric surgery department. The patiens were divided into two groups (the exuda and transude groups) according to Light's criteria. Blood plasma and parapneumonic effusions were analyzed and compared with respect to the total antioxidative and oxidative status. R Re es su ul lt ts s: : The study consisted of blood plasma and pleural effusion from 40 children with parapneumonic effusions (PPEs) (transude group [n=20]; exuda group [n=20]) and just blood plasma from 30 healthy children (control group). There were no significant difference between the groups in terms of gender and age. The blood plasma TAS level of the control group was significantly higher than the level of blood plasma TAS level of the exuda and transude groups with statistically significant (p<0.001). The value of plasma oxidative stress index (OSI) and TOS of exuda group were significantly higher than those of the control and transude groups with statistically significant (p<0.05). C Co on nc cl lu us si io on n: : This study suggests that inflammation is associated with PPE in children that increased OSI in blood plasma from PPE patients is related to tissue damage and turnover. K Ke ey yw wo or rd ds s: : Child; exudates and transudates Ö ÖZ ZE ET T A Am ma aç ç: : Plevral efüzyonlar çocuklarda yüksek morbidite ile ilişkilidir. Oksidatif stres, oksidanlar ile antioksidanlar arasındaki dengesizliği ifade eder ve akciğer hastalıkları dahil biçok hastalıkla ilişkilidir. Bu çalışmanın amacı, çocuklarda transüda ve eksüdaların ayırıcı tanısında toplam oksidatif durumun (TOS) ve total antioksidatif durumun (TAS) yararlılığını araştırmaktır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Bu çalışmada kesitsel olarak Ekim 2012'den Aralık 2013'e kadar parapnömonik efüzyon nedeniyle çocuk cerrahisi bölümüne başvuran ve torasentez yapılan hastalardan elde edilen veriler sunulmuştur. Light kriterlerine göre hastalar iki gruba ayrıldı (eksudatif ve transudatif). Kan plazması ve parapnömonik efüzyonlar analiz edilip ve toplam antioksidatif ve oksidatif duruma göre karşılaştırıldı. B Bu ul lg gu ul la ar r: : Bu çalışma, 30 sağlıklı çocuğun (kontrol grubu) kan plazmasını, 40 parapnömonik efüzyonlu (PPE) hastanın; (transüda grubu [n=20], eksüda grubu [n=20]) kan plazmasını ve pleural efüzyonu içermektedir. Cinsiyet ve yaş açısından gruplar arasında anlamlı fark yoktu. Kontrol grubunun kan plazma TAS...

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“…Several studies [7][8][9] showed that INF-Ȗ in pleural fluid may be the most sensitive and specific among other biological markers for tuberculous pleuritis. Furthermore, C-reactive protein (CRP) as a marker of inflammation has proven to be sensitive and specific for differentiating parapneumonic effusion from other etiologies of pleural effusion [10]. Another study [11] shows that a simple marker of elevated CRP level in pleural fluid may be helpful in discriminating between TBPE and MPE.…”

Section: Discussionmentioning

confidence: 99%

Proteomic pilot study of tuberculosis pleural effusion

Zhang

Fang

Liu

et al. 2015

BME

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Abstract.To discuss the differences in protein expression among tuberculosis pleural effusion (TBPE), malignant pleural effusion (MPE) and transudative pleural effusion (TSPE). We recruited 50 patients with pleural effusion, including 20 TBPEs, 17 MPEs and 13 TSPEs. Using the two-dimensional electrophoresis (2-DE) and matrix-assisted laser desorption ionization-time of flight-mass spectrometry (MALDI-TOF-MS), we acquired the peptide mass finger printings (PMFs) of featured proteins. Then, we identified characteristic proteins by searching in the protein databank of the National Center of Biotechnology Information (NCBI) and assessed their diagnostic significance. We found five characteristic proteins: C1-inhibitor (C1-INH), transthyretin (TTR), human complement fragment 3b (C3b), human ceruloplasmin (CP), and Z34c protein fragment Fc (Z34c-Fc). C1-INH shows a high expression in TBPE and a low expression in MPE while TTR and C3 show low expression in TBPE and high expressions in MPE. Z34c-Fc and CP have a higher expression in TBPE than in TSPE. No common characteristic protein was found between MPE and TSPE. Statistic analysis consisted of paired t-tests and the difference between them is significance (P 0.05). C1-inhibitor (C1-INH), transthyretin (TTR), human Complement fragment 3b (C3b), human Ceruloplasmin (CP) and Z34c protein fragment Fc (Z34c-Fc) may provide an additional perspective in the differential diagnosis of PE.

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The use of pleural fluid procalcitonin and C-reactive protein in the diagnosis of parapneumonic pleural effusions: a systemic review and meta-analysis

Cited by 32 publications

References 29 publications

The Role of Serum Procalcitonin Levels in Predicting Ascitic Fluid Infection in Hospitalized Cirrhotic and Non-cirrhotic Patients

The Role of Serum Procalcitonin Levels in Predicting Ascitic Fluid Infection in Hospitalized Cirrhotic and Non-cirrhotic Patients

What is the Diagnostic Value of Plasma Antioxidative/Oxidative Status in Parapneumonic Effusions in Children?

Proteomic pilot study of tuberculosis pleural effusion

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