A simple laboratory measurement for discrimination of transudative and exudative pleural effusion: Pleural viscosity

Abstract

We have demonstrated for the first time that pleural viscosity of the exudative effusion is higher than that of transudative effusion with high sensitivity, specificity, positive and negative predictive value. Regarding the simplicity of this measurement, it may play a valuable role in the accurate and fast discrimination of pleural fluid.

The Role of Ascitic Fluid Viscosity in the Differential Diagnosis of Ascites

“…To our knowledge, these are the first data in the literature to suggest a diagnostic utility for ascitic fluid viscosity measurement. In a Turkish study, Yetkin et al (6) reported that the viscosity of pleural exudative effusions was higher than that of transudative pleural effusions, with high sensitivity. The increment of total protein and albumin concentrations in infected pleural fluid could explain the increased pleural viscosity.…”

“…Plasma viscosity is a biochemically composite variable and is influenced by the concentration of plasma proteins and lipoproteins, of which fibrinogen is a major contributor. It has been shown that measuring plasma viscosity is a simple, reliable test, with no significant change in plasma viscosity when samples are stored frozen for up to 12 months (5,6). Additionally, pleural fluid viscosity appears to provide better discrimination between transudative and exudative pleural effusions.…”

Role of pleural viscosity in the differential diagnosis of exudative pleural effusion

“…Pleural viscosity has a high sensitivity, and specificity with high positive and negative predictive values for discriminating exudative and transudative pleural effusions. 4 The physico-chemical or rheological approach states that the contribution of individual proteins and lipoproteins to plasma viscosity depends on their concentration, MW, rigidity and asymmetrical shape. 5,6 In this study pleural fluid viscosity was used to discriminate between various aetiologies of exudative effusions such as malignant, parapneumonic, or tuberculous.…”

Getting to the heart of pleural effusions: A case study

“…Following the diagnosis of a pleural effusion, a critically important step is to determine the etiology of the effusion (Table 1). The differentiation between a transudate or an exudate provides a clue toward differential diagnosis of the pleural effusion (Yetkin, Tek, Kaya, Ciledag, & Numanoglu, 2005).…”