The Role of Pleural Fluid Procalcitonin in the Differential Diagnosis of Parapneumonic Pleural Effusions and its Relation with Pleural Fluid Ultrasound

• Published in: Southern Clinics of Istanbul Eurasia Vol. 31; no. 2; pp. 107 - 112
• Main Authors: Akkurt, Bülent, Nesrin Gürbüz Kıral, Fidan, Ali, Koç, Hacer, Salepci, Banu Musaffa, Sevda Şener Cömert
• Format: Journal Article
• Language: English; Turkish
• Published: Istanbul Kare Publishing 01.06.2020; KARE Publishing
• Subjects: Interferon; parapneumonic pleural effusion; Pleural effusion; procalcitonin; Proteins; thorax ultrasonography
• ISSN: 2587-0998; 2587-1404; 2587-0998
• DOI: 10.14744/scie.2019.37268

INTRODUCTION: Procalcitonin (PCT) is a highly specific marker for the detection of infectious diseases. In recent years, studies on this marker have been conducted in patients with pleural fluid. Our aim in this study is to investigate the role of pleural fluid procalcitonin level in distinguishing parapneumonic pleural effusion (PPE) from other causes of exudative pleural effusion and its relationship with thorax ultrasonography (USG). METHODS: A total of 128 exudative pleural effusion patients were included in this study. The patients were divided into two groups as PPE and non-PPE. Demographic findings, comorbidities, radiographic images in chest radiography and thorax USG, hemogram and CRP results, albumin, protein, lactate dehydrogenase (LDH) and glucose levels in pleural fluid and pleural fluid cell count were recorded. Pleural fluid PCT levels, serum PCT levels and thoracic USG images of PPE and non-PPE groups were compared statistically with each other. P-value <0.05 was considered statistically significant. RESULTS: Of the 128 patients, 71 (55%) were diagnosed with PPE and 57 (45%) were diagnosed with non-PPE causes. There was no significant difference in the level of pleural fluid PCT and serum PCT levels between the PPE and non-PPE groups (p=0.31 and p=0.21, respectively). No statistically significant difference was found between the anechoic fluids and the complex pleural effusion without septum in the PPE and non-PPE groups (p=0.079 and p=0.147, respectively). However, complex septated fluids were higher in PPE group and this difference was statistically significant (p=0.003). DISCUSSION AND CONCLUSION: It was found that the pleural fluid PCT and serum PCT measurements in the PPE did not have a diagnostic value. Pleural fluid PCT/serum PCT ratio were not significantly different between the two groups. In addition, there was no correlation between thoracic USG images and PCT levels.