PURPOSE: To address the value of plasma B-type natriuretic peptide (BNP)in pleural exudative effusions and to identify a relation between high level of plasma BNP and histological type by means of medical thoracoscopy.
METHODS: We evaluated 99 consecutive patients (pts) with pleural exudative effusions; plasma BNP concentrations were measured at the admission and a BNP cut-off for positivity was considered >100 pg/mL; all 99 pts underwent pleurocentesis; then, only BNP positive pts underwent echocardiography; all 99 pts underwent medical thoracoscopy; 43 pts were females, 56 males (range: 37-87 years). The final diagnosis of pleural disease was assessed by histological criteria.
RESULTS: We observed that 36 of the 99 patients showed values of plasma BNP > 100 pg/mL; these were classified by means of histological criteria following: 8 (BNP range: 100-400 pg/mL9 of 34 pts with Malignant Mesothelioma; 1 of 17 pts with Pleural Methastasis; 26 (BNP range: 105-1610 pg/mL) of 45 pts with Chronic Pleuritis; none of 2 pts with Tubercolosis Effusion, 1 of 1 pts with Eosinophilic Pleurisy. BNP was positive in 18% of pleural cancers and in 58% of benign diseases.
CONCLUSION: Plasma BNP concentration was significantly higher in patients with benign effusions than in those patients with malignant effusions (p< 0.005). A high BNP in pleural effusion can not exclude a medical thoracoscopy to obtain the diagnosis of pleural disease.
CLINICAL IMPLICATIONS: We conclude that high BNP values in pleural effusions can not exclude a medical thoracoscopy to obtain the diagnosis of pleural disease.
DISCLOSURE: Lorenza Bancalari, No Financial Disclosure Information; No Product/Research Disclosure Information