title: Pleural-fluid myeloperoxidase in complicated and noncomplicated parapneumonic pleural effusions.
abstract: The diagnostic accuracy of myeloperoxidase (MPO) in pleural fluid, for differentiating between complicated and noncomplicated parapneumonic pleural effusions (PPE) evaluated prospectively. Seventy patients aged >18 yrs with PPE (36 complicated and 34 noncomplicated) were studied after admission to a tertiary referral teaching hospital. MPO concentration was measured in plasma and pleural fluid using a double-antibody competitive radioimmunoassay. The concentrations of MPO in complicated and noncomplicated PPE were compared using a Mann-Whitney U-test and multiple logistic regression models were used to predict the odds that an effusion was complicated. MPO pleural-fluid concentrations were significantly higher in complicated than in noncomplicated PPE. After excluding purulent effusions, pleural-fluid MPO was the marker that best differentiated between the two types of PPE: the area under the receiver operating characteristic curve was 0.912, the sensitivity was 87.5% and the specificity was 85.1% at a cut-point limit of 3.000 microg x L(-1). The authors concluded that the concentration of pleural-fluid myeloperoxidase helps to differentiate between nonpurulent complicated and noncomplicated parapneumonic pleural effusions.
authors.affiliation: Dept of Internal Medicine, Vall d'Hebron General Hospital, Barcelona, Spain. 18502jam@comb.es
authors.forename: J
authors.initials: J
authors.lastname: Alegre
authors.forename: J
authors.initials: J
authors.lastname: Jufresa
authors.forename: R
authors.initials: R
authors.lastname: Segura
authors.forename: A
authors.initials: A
authors.lastname: Ferrer
authors.forename: L
authors.initials: L
authors.lastname: Armadans
authors.forename: C
authors.initials: C
authors.lastname: Aleman
authors.forename: R
authors.initials: R
authors.lastname: Marti
authors.forename: E
authors.initials: E
authors.lastname: Ruiz
authors.forename: T
authors.initials: T
authors.lastname: Fernández de Sevilla
mesh_terms: D015415:Biomarkers / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D009195:Peroxidase / Q000032:analysis*; D010996:Pleural Effusion / Q000201:enzymology* / Q000209:etiology / Q000473:pathology; D011014:Pneumonia / Q000150:complications* / Q000175:diagnosis; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000201:enzymology; D011446:Prospective Studies; D012372:ROC Curve; D011863:Radioimmunoassay; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D009195:Peroxidase