[Pleural thickening in tuberculous pleural effusion. The associated factors].
We aimed to determine which factors were related to the development of residual pleural thickening (RPT) after completion of prescribed treatment. Sixty-two patients with pleural tuberculosis (PTB) were assigned to 2 groups according to the presence or absence of RPT > 2 mm in the side and lower portion of a chest film after completion of prescribed treatment. No patient had been given corticoids. Thickening developed in 72.6%, more often in men (OR, 4.06; p = 0.034), in older patients (36 +/- 21 versus 27 +/- 12 years; p = 0.05). Smoking, size of effusion, duration of symptoms, encapsulation, PPD, pleural biopsy, bacteriology and pH, glucose, proteins and cholesterol in pleural fluids, as well as their respective pleura/serum coefficients, were similar in both groups. Pleural LDH (LDHp) and its pleura/serum coefficient (LDHp/LDHs) were 454.3 +/- 234.6 U/l and 3.21 +/- 1.67 U/l in the group with RPT and 306.0 +/- 137.2 U/l and 2.00 +/- 1.16 in the group with no sequelae (p = 0.004 and p = 0.016, respectively). Using 2.10 as the cutoff for LDHp/LDHs, sensitivity was 78.9% and specificity was 71.4%, giving a positive predictive value of 88.2% and a negative predictive value of 55.5%. We conclude that RPT a) is a frequent complication, b) is mainly found in men, c) is age-related and d) can be fairly safely predicted using 2.10 as the cutoff for LDHp/LDHs.
Soler
J J
JJ
Servicio de Neumología, Hospital Universitario La Fe, Valencia.
Gil Suay
V
V
Cordero
P
P
Perpiñá
M
M
Martínez
E
E
Sanchis
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D016009:Chi-Square Distribution; D002648:Child; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010994:Pleura / Q000473:pathology*; D010996:Pleural Effusion / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D011677:Punctures; D012372:ROC Curve; D014396:Tuberculosis, Pleural / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy
Engrosamiento pleural en el derrame pleural tuberculoso. Factores asociados.