Pleural effusion - laboratories in common cause ppsx

Pleural effusion - laboratories in
common cause



1. Normal:
- Clear ultrafiltrate of plasma that originates from the parietal pleura
- pH 7.60-7.64
- Protein content less than 2% (1-2 g/dL)
- Fewer than 1000 WBCs per cubic millimeter
- Glucose content similar to that of plasma
- Lactate dehydrogenase (LDH) less than 50% of plasma
2. Most common cause
- Left heart failure
- Pneumonia
- Malignancy
- Pulmonary embolism
- Viral disease
Add: Tuberculosis, empyema

3. Case
a. Left heart failure
- Clear/serous/light yellow
- Nucleated cells <5k
- Protein less than 2%
- Serum LDH ratio <0,6 or Pleural fluid LDH<0,67 of upper limit of normal for
serum LDH
- Glucose content similar to that of plasma.
b. Pneumonia/Empyema
- Purulent/turbid/brown

- Nucleated cells>50k, neutrophilia
- Glucose <60mg/dL
- LDH>1000 IU/L in empyema
- pH<7,3.

c. Malignancy
- Bloody/serosanguineous
- Nucleated cells<5k, eosinophil>10%
- LDH >1000 UI/L
- Glucose <60 mg/dL
- pH <7,3
d. Tuberculosis
- Nucleated cells <5k, lymphocytosis (85%)
- Protein > 4%.
- Glucose <60 mg/dL
Soucre: Medscape, Washington's manual of medical therapeutics.