The usefulness of pleural fluid presepsin, C-reactive protein, and procalcitonin in distinguishing different causes of pleural effusions

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Title
The usefulness of pleural fluid presepsin, C-reactive protein, and procalcitonin in distinguishing different causes of pleural effusions
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Description

Abstract
BACKGROUND:

We aimed to determine the presepsin concentration in pleural fluid from patients with pleural effusions of different aetiologies and to compare its diagnostic value with that of pleural fluid C-reactive protein (CRP) and procalcitonin (PCT).
METHODS:

We enrolled 132 patients with pleural effusion who underwent diagnostic evaluation, and we classified them into six categories: empyema, parapneumonic effusion, tuberculous effusion, malignant effusion, paramalignant effusion, and transudate effusion. Additionally, all pleural effusions were categorised as infectious or non-infectious effusions.
RESULTS:

Receiver operating characteristic analysis was used to evaluate diagnostic performance. When diagnosing empyema, the marker with the highest sensitivity was pleural fluid presepsin (cut-off: 754 pg/mL; sensitivity: 90.9%, specificity: 74.4%) and that with the highest specificity was pleural fluid CRP (cut-off: 4.91 mg/dL; sensitivity: 63.6%, specificity: 89.3%). Pleural fluid PCT tended to be lower in patients with empyema than in those with parapneumonic effusion, but this was not useful for the diagnosis of empyema. When diagnosing infectious pleural effusion, a combination of pleural fluid CRP (cut-off: 2.59 mg/dL) and presepsin (cut-off: 680 pg/mL) produced the highest diagnostic accuracy (83.3%).
CONCLUSIONS:

Pleural fluid presepsin was found at high levels in patients with empyema and parapneumonic effusion. This pattern closely resembles the previously reported pattern of pleural fluid CRP. Some combinations of pleural fluid inflammatory markers may be more clinically useful than these markers in isolation.

KEYWORDS:

C-reactive protein; Empyema; Pleural effusion; Presepsin; Procalcitonin

(医博甲721)

Author
著者 渡邊 直樹
著者(ヨミ) ワタナベ ナオキ
著者(別表記) Watanabe Naoki
Publication Title
BMC Pulmonary Medicine
Volume
18
Issue
1
Start Page
176
End Page
176
Publisher
BMC (part of Springer Nature)
Published Date
2018-11-23
ISSN
1471-2466
PMID
30470216
DOI
10.1186/s12890-018-0740-3
Resource Type
Thesis or Dissertation
Language
eng
Relation
出版社版DOIリンク(URL): https://doi.org/10.1186/s12890-018-0740-3
PMCID: PMC6251181
Resource URL
https://doi.org/10.1186/s12890-018-0740-3
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6251181/
Relation(isVersionOf)
Publisher's Version.
Rights
Copyright © The Author(s). 2018
Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
DOI: https://doi.org/10.1186/s12890-018-0740-3
Text Version
ETD
Grant ID
博甲第721号
Grant Date
2019-03-24
Degree Name
博士(医学)
Grantor
香川大学
Set
香川大学
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