Distinguishing Exudative from Transudative Effusion by Using Pleural Fluid Cholesterol and Bilirubin in Comparative Study to Light’s Criteria

الملخص

Background: Pleural effusions are often classified into exudates and transudates based on certain biochemical parameters which include protein; lactate dehydrogenase (Light’s criteria); cholesterol and bilirubin, so the aim of the study is to evaluate the importance of pleural fluid cholesterol and bilirubin in differentiating exudative from transudate pleural effusion. Method: Fifty patients with pleural effusion were evaluated for pleural fluid protein, lactate dehydrogenase (LDH), cholesterol and bilirubin and compared simultaneously with drawn blood sample for protein, LDH and bilirubin. Results: In this study cholesterol in pleural fluid has a 94%, 100% sensitivity and specificity respectively and bilirubin ratio (pleural fluid bilirubin/serum bilirubin) has a sensitivity of 88% and specificity of 85% while the parameters of Light’s criteria ie protein ratio (fluid protein/serum protein) has 88%, 85% sensitivity and specificity respectively and LDH ratio (fluid LDH/serum LDH) has a sensitivity of 100% and specificity of 71%. Conclusion: Pleural fluid cholesterol and bilirubin ratio have a better sensitivity and specificity in differentiating exudative from transudative pleural effusion than the parameters of Light’s measures.