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https://www.readbyqxmd.com/read/29660258/pleural-tuberculosis-a-concise-clinical-review
#1
Jane A Shaw, Elvis M Irusen, Andreas H Diacon, Coenraad Fn Koegelenberg
Tuberculosis (TB) is the leading infectious cause of death worldwide, and the commonest cause of death in people living with HIV. Globally, pleural TB remains one of the most frequent causes of pleural exudates, particularly in TB-endemic areas and in the HIV positive population. Most TB pleural effusions are exudates with high adenosine deaminase (ADA), lymphocyte-rich, straw-coloured and free flowing, with a low yield on mycobacterial culture. TB pleurisy can also present as loculated neutrophil-predominant effusions which mimic parapneumonic effusions...
April 16, 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29526951/igg4-related-pleuritis-with-elevated-adenosine-deaminase-in-pleural-effusion-a-case-report
#2
Atsushi Nagayasu, Satoshi Kubo, Kazuhisa Nakano, Shingo Nakayamada, Shigeru Iwata, Ippei Miyagawa, Shunsuke Fukuyo, Kazuyoshi Saito, Yoshiya Tanaka
An 81-year-old man was admitted with bilateral pleural effusion. A clinical examination showed lymphocytic pleura effusion and elevated serum IgG4 levels, so that IgG4-related disease was suggested, whereas tuberculous pleurisy was suspected because of high adenosine deaminase (ADA) levels in the pleural effusion. A surgical pleural biopsy revealed that there were large numbers of IgG4-positive cells and IgG4/IgG positive cell ratio exceeded 40% in several sites. Accordingly, we diagnosed IgG4-related pleuritis and treated with the patient with glucocorticoid therapy...
March 9, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29408477/development-of-a-clinical-prediction-rule-for-diagnosis-of-pleural-tuberculosis-in-peru
#3
Lely Solari, Alonso Soto, Patrick Van der Stuyft
OBJECTIVES: To develop a Clinical Prediction Rule (CPR) for diagnosis of Pleural Tuberculosis (PT) in patients with pleural exudates in Peru. METHODS: We obtained clinical and laboratory information in patients attending 2 reference hospitals in Lima, Peru with exudative pleural effusion. Predictive findings associated with pleural tuberculosis in a multiple logistic regression model were used to develop the CPR. Definite diagnosis of PT was based on a composite reference standard including bacteriologic and/or histologic analysis of pleural fluid and pleural biopsy specimens...
February 2, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29381918/diagnosis-of-tuberculous-pleurisy-with-combination-of-adenosine-deaminase-and-interferon-%C3%AE-immunospot-assay-in-a-tuberculosis-endemic-population-a-prospective-cohort-study
#4
Han-Yan Xu, Cheng-Ye Li, Shan-Shan Su, Li Yang, Min Ye, Jun-Ru Ye, Pei-Pei Ke, Cheng-Shui Chen, Yu-Peng Xie, Yu-Ping Li
The aim of this study was to identify the optimal cut-off value of T cell enzyme-linked immunospot assay for tuberculosis (T-SPOT.TB) and evaluate its diagnostic performance alone (in the peripheral blood) or in combination with the adenosine deaminase (ADA) activity test (in peripheral blood and the pleural fluid) in patients with tuberculous pleurisy.Adult patients presenting with pleural effusion were included in this prospective cohort study. Tuberculous pleurisy was diagnosed by T-SPOT.TB in peripheral blood and a combination of T-SPOT...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29353318/diagnostic-value-of-vascular-endothelial-growth-factor-transforming-growth-factor-%C3%AE-interleukin-8-and-the-ratio-of-lactate-dehydrogenase-to-adenosine-deaminase-in-pleural-effusion
#5
Takeshi Saraya, Kosuke Ohkuma, Takayasu Watanabe, Sunao Mikura, Fumi Kobayashi, Junpei Aso, Hiroki Nunokawa, Kojiro Honda, Yukari Ogawa, Masaki Tamura, Mitsuru Sada, Miku Oda, Manami Inoue, Takuma Yokoyama, Daisuke Kurai, Haruyuki Ishii, Hirokazu Kimura, Hajime Takizawa
PURPOSE: We studied the diagnostic value of cytokines, including vascular endothelial growth factor (VEGF), transforming growth factor-β (TGF-β), and interleukin-8 (IL-8), and the ratio of lactate dehydrogenase (LDH) to adenosine deaminase (ADA) in pleural fluid. METHODS: Prospective analysis of 44 inpatients or outpatients with pleural fluid, from December 2016 to March 2017 was conducted. RESULTS: We enrolled patients with malignant pleural effusion (MPE, N = 15), empyema (N = 11), parapneumonic effusion (PPE, N = 7), chronic renal failure (CRF)/chronic heart failure (CHF) (N = 7), and tuberculous pleural effusion (TBPE, N = 4)...
April 2018: Lung
https://www.readbyqxmd.com/read/29332656/germ-cell-tumor-causing-pleural-effusion-a-diagnostic-dilemma
#6
Surabhi Jaggi, Reetu Kundu, Sanjeev Binji, Uma Handa, Varinder Saini
Straw colored pleural fluid with raised adenosine deaminase (ADA) levels in young healthy adults usually raises suspicion of tuberculosis, sometimes leading to laxity in carrying thorough physical examination and missing out some important clues with potential disastrous consequences. A 35-year-old male was diagnosed to have left pleural effusion and anti-tubercular treatment was started on the basis of straw colored, lymphocyte-predominant pleural fluid with significantly raised ADA levels. When there was no improvement after 1 month of treatment he was investigated further and found to have a mediastinal mass along with hydro-pneumothorax...
January 2018: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/29297451/cxcr3-ligands-in-pleural-fluid-as-markers-for-the-diagnosis-of-tuberculous-pleural-effusion
#7
W Chung, Y Jung, K Lee, J Park, S Sheen, K Park
SETTING: A tertiary care academic medical centre. OBJECTIVE: To evaluate the clinical usefulness of C-X-C motif chemokine receptor 3 (CXCR3) ligands in tuberculous pleural effusion (TPE). DESIGN: We recruited 336 patients with pleural effusion due to various causes. Concentrations of interferon-gamma (IFN-γ) and the CXCR3 ligands CXCL9 and CXCL11 were determined using enzyme immunoassays; adenosine deaminase (ADA) activity was measured in pleural fluid and serum...
December 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/29218743/repeatability-of-pleural-adenosine-deaminase-measurements-in-diagnostic-evaluation-of-pleural-effusions
#8
Ourania S Kotsiou, Panagiota Tzortzi, Rafailia A A Beta, Athanasios Kyritsis, Konstantinos I Gourgoulianis
BACKGROUND: A follow-up thoracentesis is proposed in suspected atypical tuberculosis cases. The study aimed to define the variability of pleural ADA values across repeated thoracenteses in different types of pleural effusions (PEs) and to evaluate whether ADA variance, in regard to the cutoff value of 40 U/L, affected final diagnosis. METHODS: A total of 131 patients with PEs of various etiologies underwent three repeated thoracenteses. ADA values were subsequently estimated...
December 7, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/29208371/integrated-semi-targeted-metabolomics-analysis-reveals-distinct-metabolic-dysregulation-in-pleural-effusion-caused-by-tuberculosis-and-malignancy
#9
Nanying Che, Yan Ma, Huabin Ruan, Lina Xu, Xueying Wang, Xinting Yang, Xiaohui Liu
BACKGROUND: Tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE) are the 2 most frequent causes of exudative pleural effusions (PEs). However, the clinical differentiation is challenging. METHODS: Metabolic signatures in pleural effusion from 156 patients were profiled. An integrated semi-targeted metabolomics platform was incorporated for high throughput metabolite identification and quantitation. In this platform, orbitrap based mass spectrometry with data dependent MS/MS acquisition was applied in the analysis...
February 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29202740/the-pleural-fluid-lactate-dehydrogenase-adenosine-deaminase-ratio-differentiates-between-tuberculous-and-parapneumonic-pleural-effusions
#10
Jinlin Wang, Jun Liu, Xiaohong Xie, Panxiao Shen, Jianxing He, Yunxiang Zeng
BACKGROUND: Although pleural fluid lactate dehydrogenase (LDH) and adenosine deaminase (ADA) levels are often used to distinguish between tuberculous pleural effusion (TPE) and parapneumonic pleural effusion (PPE), this can be challenging as the LDH level may vary from normal to severely increased in PPE and a significantly elevated ADA is frequently measured in both conditions. In this study, we evaluated use of the pleural fluid LDH/ADA ratio as a new parameter to discriminate TPE from PPE...
December 4, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29021481/cryptococcal-pleuritis-presenting-with-lymphocyte-predominant-and-high-levels-of-adenosine-deaminase-in-pleural-effusions-coincident-with-pulmonary-tuberculosis
#11
Yoshitomo Kushima, Hidenori Takizawa, Yasutaka Machida, Takafumi Umetsu, Naoya Ikeda, Masaaki Miyoshi, Kazuyuki Chibana, Yasuo Shimizu, Akihiro Takemasa, Yoshiki Ishii
Co-infection with cryptococcus and tuberculosis has rarely been reported. We herein report a case of an 80-year-old man with cryptococcal pleuritis concurrent with pulmonary tuberculosis. He was admitted for progression of left pleural effusion and consolidation in the left upper lobe. Culture for Mycobacterium tuberculosis was positive in sputum, and analyses of pleural effusion revealed lymphocyte-predominant high levels of adenosine deaminase (ADA). Medical thoracoscopy revealed massive infiltration of Cryptococcus neoformans in pleura without granuloma...
January 1, 2018: Internal Medicine
https://www.readbyqxmd.com/read/28864369/predictive-factors-and-treatment-outcomes-of-tuberculous-pleural-effusion-in-patients-with-cancer-and-pleural-effusion
#12
Jaehee Lee, Yong Dae Lee, Jae Kwang Lim, Deok Heon Lee, Seung Soo Yoo, Shin Yup Lee, Seung Ick Cha, Jae Yong Park, Chang Ho Kim
BACKGROUND: Patients with cancer are at an increased risk of tuberculosis. As pleural effusion has great clinical significance in patients with cancer, the differential diagnosis between tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE) is important. However, the predictive factors and treatment outcomes of TPE in patients with cancer have rarely been studied. MATERIALS AND METHODS: Confirmed TPE cases identified at cancer diagnosis and during anticancer management from 2008-2015 were retrospectively investigated...
August 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28799302/clinical-profile-of-patients-presenting-with-malignant-pleural-effusion-to-a-tertiary-health-care-centre
#13
Nitin Gadewad, Kunal Deokar, Shivhari Ghorpade
BACKGROUND: Malignant pleural effusions are one of the leading causes of exudative pleural effusions. We studied the clinical profile of patients presenting with malignant pleural effusion, their cytological and histopathological features and the efficacy of pleurodesis in preventing recurrence. MATERIALS AND METHODS: 100 patients who were positive for malignant cells in pleural fluid cytology or pleural biopsy were recruited. After history and clinical examination, Chest radiographs, Computed tomography of chest were performed...
August 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28728264/-exploratory-research-on-diagnostic-essentials-of-pediatric-tuberculous-pleurisy
#14
H Xu, J R Liu, S Y Zhao
Objective: To summarize the clinical diagnostic essentials of pediatric tuberculous pleurisy so as to reduce the misdiagnosis rate. Method: A retrospective study was conducted on 113 cases of tuberculous pleurisy who were seen from August 2006 to September 2014 in the second Department of Respiratory Medicine, Beijing Children's Hospital Affiliated to Capital Medical University. Meanwhile, another 113 cases of children over 5 years of age with mycoplasma pneumoniae pneumonia complicated with pleural effusion were randomly selected as control group...
July 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28727272/performance-of-clinical-prediction-rules-for-diagnosis-of-pleural-tuberculosis-in-a-high-incidence-setting
#15
Lely Solari, Alonso Soto, Patrick Van der Stuyft
OBJECTIVES: Diagnosis of pleural tuberculosis (PT) is still a challenge, particularly in resource-constrained settings. Alternative diagnostic tools are needed. We aimed at evaluating the utility of Clinical Prediction Rules (CPRs) for diagnosis of pleural tuberculosis in Peru. METHODS: We identified CPRs for diagnosis of PT through a structured literature search. CPRs using high-complexity tests, as defined by the FDA, were excluded. We applied the identified CPRs to patients with pleural exudates attending two third-level hospitals in Lima, Peru, a setting with high incidence of tuberculosis...
October 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28648009/-diagnostic-performance-of-t-spot-tb-on-peripheral-blood-in-combination-with-adenosine-deaminase-on-pleural-fluid-for-the-diagnosis-of-tuberculous-pleurisy-within-different-age-group
#16
H Y Xu, D Q Zhang, J R Ye, S S Su, Y P Xie, C S Chen, Y P Li
Objective: To evaluate the performance of T cell enzyme-linked immuno-spot assay (T-SPOT) on peripheral blood in combination with adenosine deaminase (ADA) on pleural fluid for diagnosis of tuberculous (TB) pleurisy within different age groups. Methods: The data of patients with pleural effusion from the Department of Pulmonary and Critical Care Medicine of the First Affiliated Hospital of Wenzhou Medical University from April 2012 to November 2016 were retrospectively analyzed, and the diagnoses of these patients were histopathologically confirmed through medical thoracoscopy...
June 27, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28545517/evaluation-of-two-strategies-for-the-interpretation-of-tumour-markers-in-pleural-effusions
#17
Jaume Trapé, Francesc Sant, Josefina Franquesa, Jesús Montesinos, Anna Arnau, Maria Sala, Oscar Bernadich, Esperanza Martín, Damià Perich, Concha Pérez, Joan Lopez, Sandra Ros, Enrique Esteve, Rafael Pérez, Jordi Aligué, Gabriel Gurt, Silvia Catot, Montserrat Domenech, Joan Bosch, Josep Miquel Badal, Mariona Bonet, Rafael Molina, Josep Ordeig
BACKGROUND: Pleural effusions present a diagnostic challenge. Approximately 20% are associated with cancer and some 50% require invasive procedures to perform diagnosis. Determination of tumour markers may help to identify patients with malignant effusions. Two strategies are used to obtain high specificity in the differential diagnosis of malignant pleural effusions: a) high cut-off, and b) fluid/serum (F/S) ratio and low cut-off. The aim of this study is to compare these two strategies and to establish whether the identification of possible false positives using benign biomarkers - ADA, CRP and % of polymorphonuclear cells - improves diagnostic accuracy...
May 25, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28494727/expression-of-toll-like-receptor-2-and-toll-like-receptor-4-in-tuberculous-pleural-effusion
#18
Yingzhong Lin, Tingmei Feng, Jiao Lan, Chunxia Chen, Zhiqiang Qin, Yanbin Wu, Huanzhong Shi, Jianbo Ye, Caizhou Wei, Wu Wang, Luying Huang
BACKGROUND: Toll-like receptor-2 (TLR2) and Toll-like receptor-4 (TLR4) have been reported to play a crucial role in tuberculosis, however, little is known about their expression in tuberculous pleuritis. OBJECTIVE: The goal of this work is to explore the expressions of TLR2 and TLR4 in tuberculous pleuritis and their predominant expressions on cells. METHODS: Levels of soluble TLR2 and TLR4 by enzyme linked immunosorbent assay (ELISA) in 58 patients with tuberculous pleural effusion (PE) and 43 patients with malignant PE were determined...
2017: Medicinal Chemistry
https://www.readbyqxmd.com/read/28410823/the-case-for-performing-pleural-biopsies-for-the-aetiological-diagnosis-of-exudates-yes
#19
F Rodriguez-Panadero
Pleural biopsies are especially indicated in the following circumstances: a) inconclusive pleural fluid analysis and negative sputum study, if adenosine deaminase (ADA) levels are unavailable; b) suspected multi-resistant tuberculosis; c) a need for differentiating tuberculous pleurisy (if it progresses with neutrophilia) and complicated parapneumonic effusion; d) malignant pleural effusion coexisting with very high ADA levels; e) effusion coexisting with lung cancer and negative pleural cytology; f) suspected mesothelioma; and g) need for implementing re-treatment for patients with relapse after chemotherapy...
October 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28119750/mycobacterium-tuberculosis-esat6-and-cpf10-induce-adenosine-deaminase-2-mrna-expression-in-monocyte-derived-macrophages
#20
Mi Jung Bae, Suyeon Ryu, Ha-Jeong Kim, Seung Ick Cha, Chang Ho Kim, Jaehee Lee
BACKGROUND: Delayed hypersensitivity plays a large role in the pathogenesis of tuberculous pleural effusion (TPE). Macrophages infected with live Mycobacterium tuberculosis (MTB) increase the levels of adenosine deaminase2 (ADA2) in the pleural fluid of TPE patients. However, it is as yet unclear whether ADA2 can be produced by macrophages when challenged with MTB antigens alone. This study therefore evaluated the levels of ADA2 mRNA expression, using monocyte-derived macrophages (MDMs) stimulated with MTB antigens...
January 2017: Tuberculosis and Respiratory Diseases
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