Cholesterol in the separation of transudates and exudates.
The Light criteria represent the most acceptable method to separate transudates and exudates. However, approximately 10% of patients with transudates, especially those with congestive heart disease, are misdiagnosed with these criteria. To improve diagnostic accuracy, many biochemical markers have been proposed as alternatives to differentiate transudates and exudates. Cholesterol has raised particular interest because only pleural fluid is needed, which makes blood samples unnecessary and simplifies the procedure. In most clinical studies, cholesterol has been shown to be as sensitive as the Light criteria, although it is less specific. Other randomized studies are necessary to determine the real potential value of pleural-fluid cholesterol measurements. Studies of pleural-fluid cholesterol are aimed at better understanding the mechanisms by which cholesterol enters the pleural cavity and its role in diseases. The ideal cutoff point of cholesterol to differentiate transudates and exudates is still unknown. Recently, aspects of the cholesterol turnover in diseases have raised great interest. Cholesterol generated great interest after it was related to coronary artery diseases. The involvement of cholesterol in the atherosclerotic process is well known, although its importance in body cavities is still unclear.
Vaz
M A
MA
Division of Respiratory Diseases, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil. macvaz@mailexcite.com
Marchi
E
E
Vargas
F S
FS
D002784:Cholesterol / Q000032:analysis*; D005122:Exudates and Transudates / Q000378:metabolism*; D006801:Humans; D010994:Pleura / Q000378:metabolism; D010995:Pleural Diseases / Q000378:metabolism*
D002784:Cholesterol