Amylase Levels in Pleural Effusions

Villena, Victoria; Pérez, Virginia; Pozo, Francisco del; López-Encuentra, Ángel; Echave-Sustaeta, José; Arenas, Joaquı́n; Escribano, P. Martín

doi:10.1378/chest.121.2.470

Cited by 54 publications

(28 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…(3) However, the correct classification of pleural fluid as an exudate or a transudate is mandatory. The diagnostic yield of the test or tests must be satisfactory, because a transudate indicates a low likelihood of a specific pleural disease and an exudate indicates the opposite.…”

Section: Introductionmentioning

confidence: 99%

Dosagem de proteínas totais e desidrogenase lática para o diagnóstico de transudatos e exsudatos pleurais: redefinindo o critério clássico com uma nova abordagem estatística

et al. 2010

View full text Add to dashboard Cite

Objective: To propose a new classification criterion for the differentiation between pleural exudates and transudates-quantifying total proteins in pleural fluid (TP-PF) and lactate dehydrogenase in pleural fluid (LDH-PF) exclusively-as well as to compare this new criterion with the classical criterion in terms of diagnostic yield. Methods: This was an observational, cross-sectional study with a within-subject design, comprising 181 patients with pleural effusion treated at two university hospitals in the state of Rio de Janeiro, Brazil, between 2003 and. The diagnostic parameters included in the classical criterion were identified, as were those included in the new criterion. Results: Of the 181 patients, 152 and 29 were diagnosed with pleural exudates and pleural transudates, respectively. For the classical criterion, the sensitivity, specificity, and accuracy for the diagnosis of pleural exudates were, respectively, 99.8%, 68.6%, and 94.5%, whereas the corresponding values for the diagnosis of pleural transudates were 76.1%, 90.1%, and 87.6%. For the new criterion (cut-off points set at 3.4 g/dL for TP-PF and 328.0 U/L for LDH-PF), the sensitivity, specificity, and accuracy for the diagnosis of exudates were, respectively, 99.4%, 72.6%, and 99.2%, whereas the corresponding values for the diagnosis of transudates were 98.5%, 83.4%, and 90.0%. The accuracy of the new criterion for the diagnosis of pleural exudates was significantly greater than was that of the classical criterion (p = 0.0022). Conclusions: The diagnostic yield was comparable between the two criteria studied. Therefore, the new classification criterion can be used in daily practice. Keywords:Pleural effusion/diagnosis; Pleural effusion/classification; Exudates and transudates. ResumoObjetivo: Propor um novo critério de classificação para a diferenciação entre exsudatos e transudatos pleurais através da dosagem de proteínas totais no líquido pleural (PT-LP) e de desidrogenase lática no líquido pleural (DHL-LP) exclusivamente, assim como comparar o rendimento diagnóstico entre esse novo critério com o critério clássico. Métodos: Estudo observacional, transversal de tipo individualizado, no qual foram selecionados 181 pacientes com derrame pleural tratados em dois hospitais universitários no estado do Rio de Janeiro (RJ) entre 2003 e 2006. Os parâmetros diagnósticos incluídos no critério clássico, assim como os do novo critério, foram determinados. Resultados: Dos 181 pacientes, 152 e 29 foram diagnosticados, respectivamente, com exsudato pleural e transudato pleural. A sensibilidade, especificidade e acurácia do critério clássico para o diagnóstico de exsudato pleural foram, respectivamente, de 99,8%, 68,6% e 94,5%, enquanto, para o diagnóstico de transudato pleural, essas foram de 76,1%, 90,1% e 87,6%. Utilizando-se os pontos de corte de 3,4 g/dL para a dosagem de PT-LP e de 328,0 U/L para aquela de DHL-LP (novo critério), a sensibilidade, especificidade e acurácia foram de, respectivamente, 99,4%, 72,6% e 99,2%, para o diagnóstico de exs...

show abstract

Section: Introductionmentioning

confidence: 99%

Dosagem de proteínas totais e desidrogenase lática para o diagnóstico de transudatos e exsudatos pleurais: redefinindo o critério clássico com uma nova abordagem estatística

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Amylase, an enzyme that is increased in the pleural fluid of patients with pancreatic diseases or rupture of the esophagus, can also be moderately elevated in malignant effusions. Joseph et al (22) and Villena et al (23) reported increased amylase levels in patients with lung cancer, although a similar finding has also been reported in cases of lymphoma and tuberculosis. In the present study, 3 (10.3%) of the patients with lymphoma and 8 (6.0%) of those with tuberculosis had amylase levels in pleural fluid that were higher than those considered normal in serum.…”

Section: Discussionmentioning

confidence: 57%

É possível diferenciar derrames pleurais linfocíticos secundários a tuberculose ou linfoma através de variáveis clínicas e laboratoriais?

et al. 2012

View full text Add to dashboard Cite

Objective: To describe clinical and laboratory characteristics in patients with tuberculosis-related or lymphomarelated lymphocytic pleural effusions, in order to identify the variables that might contribute to differentiating between these diseases. Methods: This was a retrospective study involving 159 adult HIV-negative patients with tuberculosis-related or lymphoma-related lymphocytic effusions (130 and 29 patients, respectively), treated between October of 2008 and March of 2010 at the Pleural Diseases Outpatient Clinic of the University of São Paulo School of Medicine Hospital das Clínicas Heart Institute, in the city of São Paulo, Brazil. Results: Mean age and the mean duration of symptoms were lower in the tuberculosis group than in the lymphoma group. The levels of proteins, albumin, cholesterol, amylase, and adenosine deaminase (ADA) in pleural fluid, as well as the serum levels of proteins, albumin, and amylase, were higher in the tuberculosis group, whereas serum cholesterol and triglycerides were higher in the lymphoma group. Pleural fluid leukocyte and lymphocyte counts were higher in the tuberculosis group. Of the tuberculosis group patients, none showed malignant cells; however, 4 showed atypical lymphocytes. Among the lymphoma group patients, cytology for neoplastic cells was positive, suspicious, and negative in 51.8%, 24.1%, and 24.1%, respectively. Immunophenotyping of pleural fluid was conclusive in most of the lymphoma patients. Conclusions: Our results demonstrate clinical and laboratory similarities among the patients with tuberculosis or lymphoma. Although protein and ADA levels in pleural fluid tended to be higher in the tuberculosis group than in the lymphoma group, even these variables showed an overlap. However, none of the tuberculosis group patients had pleural fluid ADA levels below the 40-U/L cut-off point.Keywords: Pleural effusion; Tuberculosis; Lymphoma; Adenosine deaminase; Diagnosis, differential. ResumoObjetivo: Descrever características clínicas e laboratoriais em pacientes com derrames pleurais linfocíticos secundários a tuberculose ou linfoma, a fim de identificar as variáveis que possam contribuir no diagnóstico diferencial dessas doenças. Métodos: Estudo retrospectivo com 159 pacientes adultos HIV negativos com derrame pleural linfocítico secundário a tuberculose ou linfoma (130 e 29 pacientes, respectivamente) tratados no Ambulatório da Pleura, Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo (SP), entre outubro de 2008 e março de 2010. Resultados: A média de idade e de duração dos sintomas foi menor no grupo tuberculose que no grupo linfoma. Os níveis pleurais de proteínas, albumina, colesterol, amilase e adenosina desaminase (ADA), assim como os níveis séricos de proteínas, albumina e amilase, foram maiores no grupo tuberculose, enquanto os níveis séricos de colesterol e triglicérides foram maiores no grupo linfoma. As contagens de leucócitos e linfócitos no líquido pleural foram maiores no grupo tub...

show abstract

“…The sensitivity, specificity, positive and negative predictive values were 94%, 28 %, 56.6%, 82.4% in serum and 0%, 82%, 0% and 45.1% respectively in pleural fluids. Victoria villena et al [15] in their large study comprising of 841 cases on pleural effusions of different etiology including tuberculosis observed that pancreatic etiology is the main cause for raised amylase levels followed by malignancies. Tuberculosis cases did not show much elevation.…”

Section: Discussionmentioning

confidence: 99%

Estimation of Amylase in Serum and Pleural Fluid among HIV Known Seronegative Patients with Tuberculous Pleural Effusion

Bukkapatnam¹,

Sasi²,

Tagore³

et al. 2016

AIMDR

View full text Add to dashboard Cite

Background: Myocardial Pleural TB is one of the most frequent extra-pulmonary manifestations of tuberculosis. Extra Pulmonary tuberculosis is the area of concern for the diagnosis of tuberculosis. Aim of this study is to estimate enzyme Amylase levels in serum and pleural fluids of HIV seronegative exudative tuberculous pleural fluids and their possible role in the diagnosis of tubercular pleural effusion. Methods: A total number of 100 patients were selected to do this study. Selected individuals were randomly included in this study as cases and controls, 50 members each. The samples of blood and pleural fluid were tested for amylase within the stipulated time, on the same day, to prevent the loss of analyte by CNP-G method. Results: Among Group I or Cases, the mean value of serum amylase and pleural fluid amylase was 53.044 and 77.122 respectively. Among Group II or controls, the mean value of serum and pleural fluid amylase was 49.508 and 63.238 respectively. Conclusion: Serum and pleural fluid Amylase levels indicate a coexisting pathology of pancreas, gastrointestinal tract and malignancies. According to our study, diagnosing Tuberculous pleural effusion by assessing amylase levels has less sensitivity and specificity.

show abstract

Amylase Levels in Pleural Effusions

Cited by 54 publications

References 11 publications

Dosagem de proteínas totais e desidrogenase lática para o diagnóstico de transudatos e exsudatos pleurais: redefinindo o critério clássico com uma nova abordagem estatística

Dosagem de proteínas totais e desidrogenase lática para o diagnóstico de transudatos e exsudatos pleurais: redefinindo o critério clássico com uma nova abordagem estatística

É possível diferenciar derrames pleurais linfocíticos secundários a tuberculose ou linfoma através de variáveis clínicas e laboratoriais?

Estimation of Amylase in Serum and Pleural Fluid among HIV Known Seronegative Patients with Tuberculous Pleural Effusion

Contact Info

Product

Resources

About