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(Chest. 2004;125:987-989.)
© 2004 American College of Chest Physicians

Comparison of Six Biological Markers for the Diagnosis of Tuberculous Pleuritis*

Akio Hiraki, MD, PhD; Keisuke Aoe, MD, PhD; Ryosuke Eda, MD, PhD; Tadashi Maeda, MD, PhD; Tomoyuki Murakami, MD, PhD; Kazuro Sugi, MD, PhD and Hiroyasu Takeyama, MD, PhD

* From the Departments of Respiratory Medicine (Drs. Hiraki, Aoe, Eda, Maeda, and Takeyama) and Clinical Research (Drs. Murakami and Sugi), National Sanyo Hospital, Respiratory Disease Center, Yamaguchi, Japan.

Correspondence to: Keisuke Aoe, MD, PhD, Department of Respiratory Medicine and Clinical Research, National Sanyo Hospital, Respiratory Disease Center, 685 Higashi-kiwa, Ube, Yamaguchi 755-0241, Japan; e-mail: keisukeaoe{at}mtf.biglobe.ne.jp

Study objective: We sought a marker to differentiate tuberculous pleural effusions from nontuberculous pleural effusions, which otherwise can be difficult.

Patients: We studied 55 patients with pleural effusions, 20 (36%) with tuberculous pleuritis and 35 (64%) with a nontuberculous etiology.

Measurement and results: Pleural fluid levels of adenosine deaminase, interferon (INF)-{gamma}, interleukin (IL)-12p40, IL-18, immunosuppressive acidic protein, and soluble IL-2 receptors were measured and were subjected to receiver operating characteristic analysis. INF-{gamma} had the greatest sensitivity and specificity for tuberculous pleuritis among the six biological markers studied.

Conclusion: The determination of INF-{gamma} levels in pleural fluid is the most informative in the diagnosis of tuberculous effusion.

Key Words: cytokine • diagnosis • pleural fluid • tuberculous pleuritis




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