medigraphic.com
ISSN 2500-7106 (Electronic)
ISSN 0123-2576 (Print)
Medicina & Laboratorio

2009, Number 01-02

<< Back Next >>

Medicina & Laboratorio 2009; 15 (01-02)

Pleural fluid

Toro RLG

Language: Spanish
References: 53
Page: 11-26
PDF size: 369.03 Kb.


ABSTRACT

Pleural effusion is defined as the abnormal accumulation of liquid in the pleural space; it is not an illness, is the result of the imbalance between the formation and the reabsorption of the liquid as a manifestation of a condition that can even be life-threatening. Clinicians are frequently faced with a patient with pleural effusion, most of the times is secondary to pleural or lung diseases, but can also be caused by systemic illnesses or cancer (primary or metastatic). It can show a quick or insidious way, with diverse manifestationsdepending on the quantity of liquid and nature, its presentation can vary from the asymptomatic patient or with pleuritic pain, to the respiratory insufficiency due to the rapid accumulation of liquid and alteration of the gas exchange. The clinical history and the physical examination are very important to evaluate the patient with pleural effusion. The appropriate approach depends on the characteristics of the liquid and its classification as a transudate or exudate, which at the same time helps to minimize the costs, narrow the diagnostic possibilities and provide an appropriate therapy.


REFERENCES

  1. Sahn SA. State of the art. The pleura. Am Rev Respir Dis 1988; 138: 184-234.

  2. Light RW. Pleural diseases. 3rd edition. Baltimore, Williams and Wilkins, 1995.

  3. Timmerman D, Moerman P, Vergote I. Meigs’ syndrome with elevated serum CA 125 levels: two case reports and review of the literature. Gynecol Oncol 1995; 59: 405-408.

  4. Light RW. Clinical practice. Pleural effusion. N Engl J Med 2002; 346: 1971-1977.

  5. Yap E, Anderson G, Donald J, Wong CA, Lee YC, Sivakumaran P. Pleural effusion in patients with pulmonary embolism. Respirology 2008; 13: 832- 836.

  6. Efrati O, Barak A. Pleural effusions in the pediatric population. Pediatr Rev 2002; 23: 417-426.

  7. Gonlugur U, Gonlugur TE. The distinction between transudates and exudates. J Biomed Sci 2005; 12: 985-990.

  8. Knight JA, Kjeldsberg CR. Cerebrospinal, synovial, and serous body fluids. In: McPherson RA, Pincus MR, eds. Henry’s clinical diagnosis and management by laboratory methods. 21st ed. China; Saunders Elsevier. 2007: 426-454.

  9. Light RW. Diagnostic principles in pleural disease. Eur Respir J 1997; 10: 476-481.

  10. Sahn SA. The diagnostic value of pleural fluid analysis. Semin Respir Crit Care Med 1995; 16: 269-278.

  11. Porcel JM, Light RW. Diagnostic approach to pleural effusion in adults. Am Fam Physician 2006; 73: 1211-1220.

  12. Esquerda A, Trujillano J, Lopez de Ullibarri I, Bielsa S, Madronero AB, Porcel JM. Classification tree analysis for the discrimination of pleural exudates and transudates. Clin Chem Lab Med 2007; 45: 82-87.

  13. Light RW. Derrame pleural. Medicina & Laboratorio 2005; 11: 511-524.

  14. Ahmad K, Gandhi MS, Smith WC, Weber KT. Bilateral pleural effusions in congestive heart failure. Am J Med Sci 2008; 335: 484-488.

  15. Spector M, Pollak JS. Management of malignant pleural effusions. Semin Respir Crit Care Med 2008; 29: 405-413.

  16. Hampson C, Lemos JA, Klein JS. Diagnosis and management of parapneumonic effusions. Semin Respir Crit Care Med 2008; 29: 414-426.

  17. Porcel JM, Vives M. Etiology and pleural fluid characteristics of large and massive effusions. Chest 2003; 124: 978-983.

  18. Scheurich JW, Keuer SP, Graham DY. Pleural effusion: comparison of clinical judgment and Light’s criteria in determining the cause. South Med J 1989; 82: 1487-1491.

  19. Nicolas-Sanchez FJ, Sarrat-Nuevo RM, Fernandez- Cabrera L, Cabau-Rubies J. [Pleural effusion associated with diclofenac]. An Med Interna 2008; 25: 154-155.

  20. The drug-induced lung diseases. http://pneumotox. com.

  21. Villena V, Lopez-Encuentra A, Garcia-Lujan R, Echave-Sustaeta J, Martinez CJ. Clinical implications of appearance of pleural fluid at thoracentesis. Chest 2004; 125: 156-159.

  22. Collins TR, Sahn SA. Thoracocentesis. Clinical value, complications, technical problems, and patient experience. Chest 1987; 91: 817-822.

  23. Maskell NA, Butland RJ. BTS guidelines for the investigation of a unilateral pleural effusion in adults. Thorax 2003; 58 Suppl 2: ii8-17.

  24. Jones PW, Moyers JP, Rogers JT, Rodriguez RM, Lee YC, Light RW. Ultrasound-guided thoracentesis: is it a safer method? Chest 2003; 123: 418- 423.

  25. Gopi A, Madhavan SM, Sharma SK, Sahn SA. Diagnosis and treatment of tuberculous pleural effusion in 2006. Chest 2007; 131: 880-889.

  26. Ziyade S, Ugurlucan M, Soysal O. Urinothorax: urine discharge from thorax. Ann Thorac Surg 2008; 85: 2141.

  27. Sahn SA. The value of pleural fluid analysis. Am J Med Sci 2008; 335: 7-15.

  28. Sahn SA. Pleural fluid analysis: narrowing the differential diagnosis. Semin Respir Crit Care Med 1987; 9: 22-29.

  29. Sahn SA, Heffner JE. Pleural fluid analysis. In: Light RW, Gary Lee YC, eds. Textbook of pleural diseases. New York; Oxford University Press. 2003: 191-209.

  30. Villena V, Perez V, Pozo F, Lopez-Encuentra A, Echave-Sustaeta J, Arenas J, et al. Amylase levels in pleural effusions: a consecutive unselected series of 841 patients. Chest 2002; 121: 470-474.

  31. Goto M, Noguchi Y, Koyama H, Hira K, Shimbo T, Fukui T. Diagnostic value of adenosine deaminase in tuberculous pleural effusion: a meta-analysis. Ann Clin Biochem 2003; 40: 374-381.

  32. Greco S, Girardi E, Masciangelo R, Capoccetta GB, Saltini C. Adenosine deaminase and interferon gamma measurements for the diagnosis of tuberculous pleurisy: a meta-analysis. Int J Tuberc Lung Dis 2003; 7: 777-786.

  33. Baba K, Hoosen AA, Langeland N, Dyrhol-Riise AM. Adenosine deaminase activity is a sensitive marker for the diagnosis of tuberculous pleuritis in patients with very low CD4 counts. PLoS ONE 2008; 3: e2788.

  34. Neves DD, Dias RM, Cunha AJ. Predictive model for the diagnosis of tuberculous pleural effusion. Braz J Infect Dis 2007; 11: 83-88.

  35. Porcel JM, Vives M. Differentiating tuberculous from malignant pleural effusions: a scoring model. Med Sci Monit 2003; 9: CR175-180.

  36. Davies PD. Tuberculosis pleuritis. In: Bouros D, ed. Pleural disease. New York; Marcel Dekker. 2004: 677-698.

  37. Porcel JM, Vives M. Adenosine deaminase levels in nontuberculous lymphocytic pleural effusions. Chest 2002; 121: 1379-1380.

  38. Jimenez Castro D, Diaz Nuevo G, Perez-Rodriguez E, Light RW. Diagnostic value of adenosine deaminase in nontuberculous lymphocytic pleural effusions. Eur Respir J 2003; 21: 220-224.

  39. Light RW. Pleural diseases. 4th ed. Baltimore; Williams & Wilkins. 2001.

  40. Gil Suay V, Martinez Moragon E, Cases Viedma E, Perpina Tordera M, Leon Fabregas M, Sanchis Aldas J. Pleural cholesterol in differentiating transudates and exudates. A prospective study of 232 cases. Respiration 1995; 62: 57-63.

  41. Talwar A, Lee HJ. A contemporary review of chylothorax. Indian J Chest Dis Allied Sci 2008; 50: 343-351.

  42. Light RW, Ball WC, Jr. Glucose and amylase in pleural effusions. Jama 1973; 225: 257-260.

  43. Good JT, Jr., Taryle DA, Maulitz RM, Kaplan RL, Sahn SA. The diagnostic value of pleural fluid pH. Chest 1980; 78: 55-59.

  44. Porcel JM, Vives M, Esquerda A, Salud A, Perez B, Rodriguez-Panadero F. Use of a panel of tumor markers (carcinoembryonic antigen, cancer antigen 125, carbohydrate antigen 15-3, and cytokeratin 19 fragments) in pleural fluid for the differential diagnosis of benign and malignant effusions. Chest 2004; 126: 1757-1763.

  45. Liang QL, Shi HZ, Qin XJ, Liang XD, Jiang J, Yang HB. Diagnostic accuracy of tumour markers for malignant pleural effusion: a meta-analysis. Thorax 2008; 63: 35-41.

  46. Antonangelo L, Vargas FS, Seiscento M, Bombarda S, Teixera L, Sales RK. Clinical and laboratory parameters in the differential diagnosis of pleural effusion secondary to tuberculosis or cancer. Clinics 2007; 62: 585-590.

  47. Villena V, Lopez Encuentra A, Echave-Sustaeta J, Alvarez Martinez C, Martin Escribano P. [Prospective study of 1,000 consecutive patients with pleural effusion. Etiology of the effusion and characteristics of the patients]. Arch Bronconeumol 2002; 38: 21-26.

  48. Adelman M, Albelda SM, Gottlieb J, Haponik EF. Diagnostic utility of pleural fluid eosinophilia. Am J Med 1984; 77: 915-920.

  49. Whitaker D. The cytology of malignant mesothelioma. Cytopathology 2000; 11: 139-151.

  50. Scherpereel A, Grigoriu BD, Astoul P. [Other thoracic cancers. Malignant pleural mesothelioma: biology and diagnosis]. Rev Mal Respir 2008; 25: 3S183-190.

  51. Marchevsky AM. Application of immunohistochemistry to the diagnosis of malignant mesothelioma. Arch Pathol Lab Med 2008; 132: 397- 401.

  52. Bielsa S, Panades MJ, Egido R, Rue M, Salud A, Matias-Guiu X, et al. [Accuracy of pleural fluid cytology in malignant effusions.]. An Med Interna 2008; 25: 173-177.

  53. Garcia LW, Ducatman BS, Wang HH. The value of multiple fluid specimens in the cytological diagnosis of malignancy. Mod Pathol 1994; 7: 665- 668.




2020     |     www.medigraphic.com