The acute-phase proteins serum amyloid A and C reactive protein in transudates and exudates.
The distinction between exudates and transudates is very important in the patient management. Here we evaluate whether the acute-phase protein serum amyloid A (SAA), in comparison with C reactive protein (CRP) and total protein (TP), can be useful in this discrimination. CRP, SAA, and TP were determined in 36 exudate samples (27 pleural and 9 ascitic) and in 12 transudates (9 pleural and 3 ascitic). CRP, SAA, and TP were measured. SAA present in the exudate corresponded to 10% of the amount found in serum, that is, the exudate/serum ratio (E/S) was 0.10 +/- 0.13. For comparison, the exudate/serum ratio for CRP and TP was 0.39 +/- 0.37 and 0.68 +/- 0.15, respectively. There was a strong positive correlation between serum and exudate SAA concentration (r = 0.764; p < 0.0001). The concentration of SAA in transudates was low and did not overlap with that found in exudates (0.02-0.21 versus 0.8-360.5 g/mL). SAA in pleural and ascitic exudates results mainly from leakage of the serum protein via the inflamed membrane. A comparison of the E/S ratio of SAA and CRP points SAA as a very good marker in discriminating between exudates and transudates.
Okino
Alessandra M
AM
Departamento de Patologia, Análises Clínicas e Toxicológicas, Centro de Ciências da Saúde, Univesidade Estadual de Londrina, CEP 86051-990 Paraná, Brazil.
Bürger
Cristiani
C
Cardoso
Jefferson R
JR
Lavado
Edson L
EL
Lotufo
Paulo A
PA
Campa
Ana
A
D000209:Acute-Phase Proteins / Q000378:metabolism*; D001201:Ascites / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D001798:Blood Proteins / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism*; D005122:Exudates and Transudates / Q000378:metabolism*; D006801:Humans; D010996:Pleural Effusion / Q000378:metabolism; D012680:Sensitivity and Specificity; D000685:Serum Amyloid A Protein / Q000378:metabolism*; D013997:Time Factors
D000209:Acute-Phase Proteins; D015415:Biomarkers; D001798:Blood Proteins; D000685:Serum Amyloid A Protein; D002097:C-Reactive Protein