[Differential diagnosis of tuberculous pleurisy by the measurement of cytokine concentration in pleural effusion].
Pleural fluids obtained from 26 patients with tuberculous pleurisy (T-group), 11 with parapneumonic pleurisy (B-group) and 21 with malignant pleurisy (M-group) were tested for their biologic parameters and cytokine concentrations. 1) The average age of T-group was over 10 years lower than that of M-group with a statistically significant difference. 2) The average CRP value of B-group and the positivity on PPD skin test of T-group were higher than those of the other groups, respectively. 3) Yellowish pleural fluids were mainly observed in T- and B-group, while bloody pleural fluids were mostly seen in M-group with a statistically significant difference. The average total protein amount and adenosine deaminase value in pleural fluid significantly increased in T-group. The percentage of polymorphonuclear leukocytes showed a significant increase in B-group, while lymphocytes significantly increased in T-group with a statistically significant difference. 4) Although no significant difference in concentrations of IL-1 beta, IL-2, IFN-gamma and TNF-alpha in serum was noticed among the three groups, the average concentrations of IFN-gamma and TNF-alpha in pleural fluid in T-group were significantly higher than those in the other groups. 5) TNF-alpha-mRNA of mononuclear cells in pleural fluid was strongly expressed in 3 out of 11 patients of T-group, while no expression was observed in 6 patients of M-group. In conclusion, the measurement of concentrations of two kinds of cytokines in pleural fluid, IFN-gamma and TNF-alpha, may be clinically useful for the differential diagnosis of tuberculous pleurisy from parapneumonic pleurisy and malignant pleurisy.
Ogawa
K
K
Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
Koga
H
H
Yang
B
B
Fukuda
M
M
Ohno
H
H
Yamamoto
Y
Y
Yanagihara
K
K
Miyamoto
J
J
Tomono
K
K
Hirakata
Y
Y
Tashiro
T
T
Kohno
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016898:Interferon-alpha / Q000032:analysis*; D007371:Interferon-gamma / Q000032:analysis*; D007375:Interleukin-1 / Q000032:analysis; D007376:Interleukin-2 / Q000032:analysis; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000276:immunology*; D014396:Tuberculosis, Pleural / Q000175:diagnosis*
D016898:Interferon-alpha; D007375:Interleukin-1; D007376:Interleukin-2; D007371:Interferon-gamma