A comparative study on initial pleural fluid findings of tuberculous pleurisy between patients with and those without pleural thickening

Lee, Sung Hyun; Yoon, Ji Ho; Lee, Dong Chea; Kim, Dae Sig; Kim, Yeong Young; Lee, Jin Woong; Yoon, Tae Yong; Kim, Ji Woon

Abstract

BACKGROUND
Indicator that can predict pleural thickening in pleural tuberculosis has not been known clearly. By the previous study, patients with pleural thickening > or =10 mm had significantly lower glucose and pH values and higher lysozyme and TNF-alpha values than those with pleural thickening <10 mm, but interferon-gamma (IFN-gamma) values were not significantly different. We studied the relationship between pleural thickening and biochemical, or immunologic finding in initial pleural fluid.
METHODS
We followed up 22 patients who had been diagnosed as pleural tuberculosis. four patients (18.1%) had pleural thickening > or =10 mm and 12 patient (54.5%) had pleural thickening > or =3 mm. Initial pleural fluid protein, LDH, pH, glucose and IFN-gamma, Interleukin-1alpha (IL-1alpha) were studied.
RESULTS
Pleural fluid levels of protein, LDH, glucose, and IFN-gamma were not statistically significant different not only between the group of pleural thickening > or =3 mm and the group of pleural thickening <3 mm, but also between the group of pleural thickening > or =10 mm and the group of pleural thickening <10 mm. The pleural fluid IFN-gamma level, the group with pleural thickening > or =3 mm (85.9+/- 37.1 U/mL) was significantly higher than without thickening (44.8+/-32.0 U/mL) (p< 0.05) and the group with pleural thickening> or =10 mm (106.9+/-8.6 U/mL) was significantly higher than without thickening (58.5+/-8.6 U/mL)(p< 0.001).
CONCLUSION
Although patient number of our study was smaller than the previous study, IFN-gamma level in initial pleural fluid of pleural tuberculosis may be considered as the predictive factor of pleural thickening.