Diagnostic methods of primary tuberculous pleural effusion in a region with high prevalence of tuberculosis. A study in Mexican population.
OBJECTIVE
1) To determine the age distribution of the patients with pleural tuberculosis in a region with high prevalence of tuberculosis; and 2) to evaluate the efficiency of the methods used in its diagnosis.


METHODS
The National Institute of Respiratory Diseases in Mexico City, a tertiary reference center for pulmonary diseases.


METHODS
A retrospective study.


METHODS
452 consecutive inpatients with diagnosis of pleural effusion from January 1991 to September 1996 were reviewed: 133 patients had a diagnosis of tuberculous pleural effusion of primary origin without parenchymal abnormalities by chest roetgenogram. The others were excluded because of reactivated tuberculosis or non-tuberculous effusion.


RESULTS
The patients had a mean age of 42 +/- 17 years (98 male, 35 female). Pleural granulomas in the morphological study were found in 87% whereas the baciloscopy and the culture of the fluid were positive in only 8% and 19% respectively. The determination of adenosine deaminase (ADA) gave a diagnostic yield of 84%.


CONCLUSIONS
1) Primary tuberculosis pleural effusion, reported in the English literature, was also present in our adults; 2) the pleural biopsy continued to be the most effective method in the diagnosis of the pathology; and 3) the determination of ADA in an area with high prevalence of the disease was a reliable and unexpensive diagnostic method.
Salazar-Lezama
M
M
Clínica de Estudios en Patología Pleural, Instituto Nacional de Enfermedades Respiratorias, México D.F.
Quiroz-Rosales
H
H
Bañales-Méndez
J L
JL
Sánchez-Guzmán
M
M
Villarreal-Velarde
H
H
Báez-Saldaña
R
R
Azcona-Martínez
E
E
Selman-Lama
M
M
D000243:Adenosine Deaminase / Q000032:analysis; D000328:Adult; D001706:Biopsy; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D010996:Pleural Effusion / Q000175:diagnosis* / Q000201:enzymology / Q000453:epidemiology / Q000382:microbiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013906:Thoracoscopy; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000201:enzymology / Q000453:epidemiology*
D000243:Adenosine Deaminase