title: Pleural fluid and serum procalcitonin as diagnostic tools in tuberculous pleurisy.
abstract: 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.
authors.affiliation: Department of Emergency Medicine, Laboratory of Biochemistry, Gulhane School of Medicine, Etlik, Ankara 06010, Turkey. erdcakir@yahoo.com
authors.forename: Erdinc
authors.initials: E
authors.lastname: Cakir
authors.forename: Omer
authors.initials: O
authors.lastname: Deniz
authors.forename: Omer
authors.initials: O
authors.lastname: Ozcan
authors.forename: Ergun
authors.initials: E
authors.lastname: Tozkoparan
authors.forename: Halil
authors.initials: H
authors.lastname: Yaman
authors.forename: Emin Ozgur
authors.initials: EO
authors.lastname: Akgul
authors.forename: Cumhur
authors.initials: C
authors.lastname: Bilgi
authors.forename: Hayati
authors.initials: H
authors.lastname: Bilgic
authors.forename: Kudret
authors.initials: K
authors.lastname: Ekiz
authors.forename: Mehmet Kemal
authors.initials: MK
authors.lastname: Erbil
mesh_terms: 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
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide