title: The lipoprotein profile of chylous and nonchylous pleural effusions.
abstract: The lipoprotein electrophoregrams and the cholesterol and triglyceride levels of the pleural fluid were evaluated for patients with chylous pleural effusions, as defined by the presence of a distinctive band of chylomicrons on the lipoprotein electrophoregram, and in patients with nonchylous effusions of various causes. One hundred forty-one patients were studied during a 3-year period. The chylous effusions had strikingly higher triglyceride levels (median 249, range 49 to 2,270 mg/dl) than the nonchylous group (median 33, range 13 to 107 mg/dl); there were no significant differences in cholesterol or protein between the two groups. The gross description of the fluid was a poor indicator of its origin, being described as consistent with chyle in less than 50% of cases of chylous effusions. The triglyceride values distinguished chylous effusion from nonchylous effusion; values greater than 110 mg/dl are highly suggestive of a chylous effusion. Equivocal cases--triglyceride values between 50 and 110 mg/dl--required lipoprotein analysis. Pleural effusions of undetermined cause, regardless of gross appearance of the fluid, require that a screening triglyceride value be obtained to rule out a chylous effusion.
mesh_terms: D002784:Cholesterol / Q000032:analysis; D002914:Chylomicrons / Q000032:analysis; D002916:Chylothorax / Q000378:metabolism*; D004586:Electrophoresis; D005260:Female; D006801:Humans; D008074:Lipoproteins / Q000032:analysis*; D008297:Male; D010996:Pleural Effusion / Q000378:metabolism*; D014280:Triglycerides / Q000032:analysis; D014461:Ultracentrifugation
chemical_list: D002914:Chylomicrons; D008074:Lipoproteins; D014280:Triglycerides; D002784:Cholesterol