Duro-pleural fistula diagnosed by beta2-transferrin.
An 81-year-old man was referred for evaluation of a chronic transudative pleural effusion that required 8 therapeutic thoracenteses over 11 months for relief of dyspnea. Extensive lumbar disk surgery had been performed 2 years prior to his onset of dyspnea. The diagnosis of duro-pleural fistula was confirmed by finding the presence of beta2-transferrin in the pleural fluid. The 'water-like' pleural fluid had a total protein of <1 gm/dl, an LDH of 92 IU/l, a glucose of 101 mg/dl, and pH of 7.55. beta2-Transferrin has a sensitivity approaching 100% and a specificity of 95% in identifying CSF leaks from head trauma. To our knowledge, this is the first report of beta2-transferrin in pleural fluid from a duro-pleural fistula.
D000368:Aged; D000369:Aged, 80 and over; D004388:Dura Mater; D006801:Humans; D008297:Male; D010995:Pleural Diseases / Q000175:diagnosis* / Q000378:metabolism; D010996:Pleural Effusion / Q000378:metabolism*; D016156:Respiratory Tract Fistula / Q000175:diagnosis* / Q000378:metabolism; D013118:Spinal Cord Diseases / Q000175:diagnosis* / Q000378:metabolism; D014168:Transferrin / Q000378:metabolism*
D014168:Transferrin