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Differential Diagnosis of Pleural Effusion by Lactate Dehydrogenase Isoenzyme Analysis

Izidore S. Lossos; Raphael Breuer; Orna Intrator; Moshe Sonenblick
Author and Funding Information

Affiliations: From the Institute of Pulmonology, Hadassah University Hospital and Hebrew University-Hadassah Medical School, Jerusalem, Israel,  From the Statistics Department, Hebrew University of Jerusalem, Jerusalem, Israel,  From the Department of Geriatrics, Shaare Zedek Medical Center, Jerusalem, Israel

Affiliations: From the Institute of Pulmonology, Hadassah University Hospital and Hebrew University-Hadassah Medical School, Jerusalem, Israel,  From the Statistics Department, Hebrew University of Jerusalem, Jerusalem, Israel,  From the Department of Geriatrics, Shaare Zedek Medical Center, Jerusalem, Israel

Affiliations: From the Institute of Pulmonology, Hadassah University Hospital and Hebrew University-Hadassah Medical School, Jerusalem, Israel,  From the Statistics Department, Hebrew University of Jerusalem, Jerusalem, Israel,  From the Department of Geriatrics, Shaare Zedek Medical Center, Jerusalem, Israel


1997 by the American College of Chest Physicians


Chest. 1997;111(3):648-651. doi:10.1378/chest.111.3.648
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Abstract

Study objective: To determine the diagnostic value of pleural fluid lactate dehydrogenase (LDH) isoenzyme analysis in the differential diagnosis of pleural fluid.

Patients and methods: Eighty-seven consecutive patients with pleural effusion caused by congestive heart failure (33), infection (33), and malignancy (21) comprised a derivation set of patients. Pleural fluid LDH activity and isoenzyme pattern were established in all patients and analyzed by the classification and regression trees (CART) method. An additional group of 20 consecutive patients comprised a validation set that was used for cross-validation of CART-derived decision tree.

Results: A decision tree, with a positive predictive value of 83%, was constructed and validated by data from a validation set of patients.

Conclusions: Pleural fluid LDH isoenzyme pattern may be helpful for the differential diagnosis of the most common causes of pleural effusions: congestive heart failure, infections, and malignancy.


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