A study of pleural effusion with reference to different diagnostic modalaties


  • Savita Jindal Department of Pulmonary Medicine, B.J. Medical College, Ahmedabad, Gujarat, India
  • Pankaj Garg Department of Medicine, GMERS Medical College, Gandhinagar, Gujarat, India
  • Amit R. Dedun Department of Pulmonary Medicine, B.J. Medical College, Ahmedabad, Gujarat, India
  • Hemant Nayi Department of Pulmonary Medicine, B.J. Medical College, Ahmedabad, Gujarat, India
  • Divyashree J Department of Pulmonary Medicine, B.J. Medical College, Ahmedabad, Gujarat, India
  • Gaurav Sahu Department of Pulmonary Medicine, B.J. Medical College, Ahmedabad, Gujarat, India




Pleural effusion (PE), Adenosine deaminase (ADA), Malignancy


Background: Aim of current study was to determine the different etiologies of pleural effusion and efficacy of diagnostic methods.

Methods: 100 patients of pleural effusion of both sexes were taken randomly coming to our institution either indoor or OPD. Inclusion criteria: 100 patients of pleural effusion of any age and of either sex in whom thoracentesis can yield minimum amount of pleural fluid for diagnostic purposes. Exclusion criteria: Patients of pleural effusion in whom fluid could not be aspirated were excluded from the study.

Results: In this study 70% of the patients were male and 30% were female. Most of the patients were between 21-30 years of age. 92% of the pleural effusion was exudative and 8% was transudative. Tuberculosis is the most common (44%) cause of pleural effusion followed by malignancy (23%), 5% of the patients remains undiagnosed. Sensitivity, specificity, NPV, PPV of Light’s criteria is 100% to differentiate between transudates and exudates. Among parameters of Light's criteria pleural LDH has highest specificity (100) and sensitivity (100) and NPV (80%). Sensitivity, specificity, NPV, PPV of ADA to differentiate between tuberculous and non tuberculous pleural effusion is 100%, 95%, 100%, 96.77% respectively. Pleural biopsy was positive in 80% of the tuberculous patients while in malignancy it was positive only in 20% of the patients.

Conclusions: Tuberculosis remains to be main cause of pleural effusion in India. Light’s criteria is most specific & sensitive to diagnose between exudative & transudative pleural fluid. ADA is highly sensitive & specific to differentiate between tuberculous & nontuberculous pleural effusion. In centres where thorascopy is not available for undiagnostic cases of pleural effusion, pleural biopsy can be helpful in fair no. of cases for diagnosis. 


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