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

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URI http://shark.lib.kagawa-u.ac.jp/kuir/metadata/28681
タイトル
The usefulness of pleural fluid presepsin, C-reactive protein, and procalcitonin in distinguishing different causes of pleural effusions
ファイル
内容記述

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)

著者
著者 渡邊 直樹
著者(ヨミ) ワタナベ ナオキ
著者(別表記) Watanabe Naoki
掲載誌
BMC Pulmonary Medicine
18
1
開始ページ
176
終了ページ
176
出版者
BMC (part of Springer Nature)
出版年月日
2018-11-23
ISSN
1471-2466
PMID
30470216
DOI
10.1186/s12890-018-0740-3
資料タイプ
学位論文
言語
英語
関連情報
出版社版DOIリンク(URL): https://doi.org/10.1186/s12890-018-0740-3
PMCID: PMC6251181
関連情報URL
https://doi.org/10.1186/s12890-018-0740-3
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6251181/
関連情報(isVersionOf)
Publisher's Version.
権利関係
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
博士論文(全文を含む)
学位授与番号
博甲第721号
学位授与年月日
2019-03-24
学位名
博士(医学)
学位授与機関
香川大学
区分
香川大学
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