Disorders of the Pleura: Disorders of the Pleura |

Clinical, Laboratory, and Microbiological Differences Between Polymorphonuclear- and Lymphocyte-Dominant TB Pleurisy FREE TO VIEW

Hayoung Choi, MD; Hae Ri Chon, MD; Woo Jin Jung, MD; Bumhee Yang, MD; Hye Yun Park, MD; Won-Jung Koh, MD
Author and Funding Information

Samsung Medical Center, Seoul, Korea (the Republic of)

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):565A. doi:10.1016/j.chest.2016.08.654
Text Size: A A A
Published online

SESSION TITLE: Disorders of the Pleura

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: There is limited information on the clinical and laboratory characteristics of lymphocyte- and polymorphonuclear (PMN) -predominent pleural effusions caused by Mycobacterium tuberculosis (MTB).

METHODS: We retrospectively analyzed 200 patients newly diagnosed with tuberculous pleurisy with lymphocyte- or PMN-predominant pleural effusions at Samsung Medical Center from January 2009 to May 2014.

RESULTS: Of the patients, 10% (19/200) had tuberculous pleural effusions containing predominantly PMNs. The diagnostic yields of Mycobacteria on culture (78.9% vs. 22.7%, P < 0.01) and MTB positivity on PCR of pleural fluid (31.6% vs. 5.0%, P = 0.01) were significantly higher in patients with PMN-dominant compared with lymphocyte-dominant effusions. The risk of co-existing parenchymal tuberculosis (as revealed by a positive AFB culture) was significantly higher in the PMN-dominant group (57.9 vs. 30.9%, P = 0.018). In addition, the PMN-predominant group had higher lactate dehydrogenase (1402 vs. 653 U/L, P < 0.001) and lower glucose (77 vs. 91 mg/dL, P = 0.020) levels than lymphocyte-dominant effusions on pleural fluid analysis. While there were no differences in the clinical manifestations (fever, cough, sputum, and pleuritic chest pain) between the two groups, the PMN-predominant group had higher inflammatory serum markers, such as the white blood cell count (8520 vs. 6,040/μL, P = 0.001) and C-reactive protein (8.61 vs. 4.5 mg/dL, P = 0.001) than lymphocyte-dominant effusions.

CONCLUSIONS: The proportion of tuberculous pleural effusions that were PMN-dominant was high, and clinical and laboratory differences were evident between lymphocyte- and PMN-dominant effusions in patients with tuberculous pleurisy.

CLINICAL IMPLICATIONS: The possibility of TB pleurisy should be considered when clinicians encounter a PMN-dominant pleural effusion. Microbiological tests are warranted for diagnosing tuberculous pleurisy in a PMN-dominant pleural effusion.

DISCLOSURE: The following authors have nothing to disclose: Hayoung Choi, Hae Ri Chon, Woo Jin Jung, Bumhee Yang, Hye Yun Park, Won-Jung Koh

No Product/Research Disclosure Information




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
Tuberculous pleural effusion. J Thorac Dis 2016;8(7):E486-94.
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543