Functional sequelae of tuberculous pleurisy in patients correctly treated.
OBJECTIVE
To assess the functional sequelae (FS) of patients with tuberculous pleurisy (TP), to analyze the influence of different factors in the occurrence of these FS, and, finally, to evaluate the relationship between the FS and roentgenographic sequelae.


METHODS
An observational, retrospective study.


METHODS
A community teaching hospital in Alicante, Spain.


METHODS
From April 1986 to July 2000, all patients with a firmly established diagnosis of TP, who had been functionally studied at the end of follow-up, were included in the study. A diagnosis of TP was considered to be definitive when the presence of granuloma on a pleural biopsy specimen was demonstrated or when a culture was positive for Mycobacterium tuberculosis in pleural fluid (PF) or tissue. The general characteristics of the study population and PF were compared in patients with or without restrictive FS (ie, FVC or TLC < 80%), looking for risk factors for developing this complication.


RESULTS
Eighty-one of 150 patients who had been treated for TP were eligible for the study. At the end of follow-up, eight patients (10%) had a restrictive FS. These patients had a lower PF lactate dehydrogenase concentration (p < 0.001), a higher PF concentration of cholesterol (p < 0.03) and triglycerides (p < 0.03), and a higher percentage of lymphocytes (p < 0.04). A weak correlation was found between the FVC and the intensity of radiographic pleural thickening (r = - 0.298; p < 0.01).


CONCLUSIONS
The FS in patients with TP is restrictive in type, infrequent, and usually mild. A higher PF lipid content or a more chronic inflammatory pleural reaction at diagnosis appear to be risk factors for developing a FS. The correlation between FS and roentgenographic sequelae is poor.
Candela
Alfredo
A
Servicio de Neumología, Hospital General Universitario de Alicante, Alicante, Spain.
Andujar
José
J
Hernández
Luis
L
Martín
Concepción
C
Barroso
Encarnación
E
Arriero
Juan M
JM
Romero
Santiago
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002784:Cholesterol / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000032:analysis; D008168:Lung / Q000503:physiopathology; D008214:Lymphocytes / Q000166:cytology; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000737:chemistry / Q000166:cytology; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D014280:Triglycerides / Q000032:analysis; D014396:Tuberculosis, Pleural / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology
D014280:Triglycerides; D002784:Cholesterol; D007770:L-Lactate Dehydrogenase