Pleural fluid and serum procalcitonin as diagnostic tools in tuberculous pleurisy.
BACKGROUND
Diagnosis of tuberculous pleuritis is difficult because of its nonspecific clinical presentation and decreased efficiency of traditional diagnostic methods. We investigated the use of procalcitonin (PCT) concentration in tuberculous pleuritis diagnosis.


METHODS
A prospective clinical study was performed with two different patient groups. A total of 28 patients were included: 18 with tuberculosis and 10 with nontuberculous pleurisy. Serum and pleural fluid PCT concentrations were evaluated before treatment.


RESULTS
Serum and pleural fluid PCT concentrations were statistically different between tuberculous and nontuberculous pleurisy groups (P = 0.012 and P = 0.004, respectively), even though they were not elevated in relation to the cut-off level of 0.5 ng/mL. A positive and significant correlation was detected between serum and pleural fluid PCT levels (r = 0.49, P = 0.008). Diagnostic specificity and sensitivity values for serum and pleural fluid PCT in discriminating tuberculous from nontuberculous pleurisy were 80% and 72.2%, and 90% and 66.7% at the 0.081 and 0.113 ng/mL cut-off values, respectively.


CONCLUSIONS
Relative to the current cut-off level of 0.5 ng/mL, PCT concentration is not a useful parameter for the diagnosis of tuberculous pleurisy. Because there were PCT levels in patients with tuberculous pleurisy that were below the current cut-off level but were significantly different from those of the nontuberculous group, the use of PCT should be further investigated.
Cakir
Erdinc
E
Department of Emergency Medicine, Laboratory of Biochemistry, Gulhane School of Medicine, Etlik, Ankara 06010, Turkey. erdcakir@yahoo.com
Deniz
Omer
O
Ozcan
Omer
O
Tozkoparan
Ergun
E
Yaman
Halil
H
Akgul
Emin Ozgur
EO
Bilgi
Cumhur
C
Bilgic
Hayati
H
Ekiz
Kudret
K
Erbil
Mehmet Kemal
MK
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000032:analysis* / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000032:analysis* / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000737:chemistry* / Q000209:etiology; D010998:Pleurisy / Q000175:diagnosis / Q000378:metabolism; D011446:Prospective Studies; D011498:Protein Precursors / Q000032:analysis* / Q000097:blood*; D012016:Reference Values; D012680:Sensitivity and Specificity; D014396:Tuberculosis, Pleural / Q000175:diagnosis* / Q000378:metabolism
D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide