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KMID : 0882419770200030243
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Korean Journal of Medicine
1977 Volume.20 No. 3 p.243 ~ p.250
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Study on the Differential Diagnosis of Pleural Effusion
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Song Heon-Soon
Song Hee-Sung
Suh Soon-Kyu
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Abstract
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Differential diagnosis of transudate and exudate of pleural effusion was evaluated by the value of LDH, protein, specific gravity and the ratio of these value to those of the serum in 82 cases with pleural effusion due to various causes. The diagnosis of transudate and exudate of pleural effusions were made by causes of underlying diseases. There were 6 cases of pleural transudates due to congestive heart failure and liver cirrhosis. There were 76 cases of pleural exudates due to tuberculous pleurisy, pneumonia and paragonimiasis.
The results were as follows:
1. The LDH in the pleural effusions was 79.5 (17~180)u/ml in transuadte and 642.1(100~2,000) u/ml in exudate. In all cases of transudate, the LDH was less than 200u/ml but in exudates LDH was more. than 200u/ml in 70 cases and was less than 200u/ml in 6 cases (7.9%).
2. The LDH ratio of pleural effusion to serum was 0.38(0.17~0.5) in transudate and 2.91(0.25~10.0) in exudate. The LDH ratio was less than 0. 6 in all cases of transudate but more than 0. 6 in 44 cases except 4 cases of which LDH ratio were less than 0.6.
3. The protein in the pleural effusion was 1.57 (0.76~3.40)gm% in transudate and 5.14(l.94~9. 60) gm% in exudate. In one cases of transudate was over 3gm% and in 2 cases of exudate the protein were under 3 gm%.
4. The protein ratio of pleural effusion to serum was 0.21(0.10~0.43) in transudate and was 0,.87 (0.32~1.45) in exudate. The ratio was under 0.5 in all cases of transudate and 2 cases of exudate but was over 0.5 in 46 cases of exudate (95.8%).
5. The specific gravity of pleural effusion was 1.012(1.009~1.019) in transudate and 1.031(1.014 ~1.057) in exudate. In one case of transudate the S.G. was higher than 1.016 and was lower than 1.016 in one cases of exudate.
6. Several combination of diagnostic criteria gives good result for differentiation of transudate but gives considerable false negative result for that of exudate.
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