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  • Title: Differential diagnosis of tuberculous pleurisy by measurement of cytokine concentrations in pleural effusion.
    Author: Ogawa K, Koga H, Hirakata Y, Tomono K, Tashiro T, Kohno S.
    Journal: Tuber Lung Dis; 1997; 78(1):29-34. PubMed ID: 9666960.
    Abstract:
    STUDY OBJECTIVE: Measurement of cytokine concentration in serum and pleural effusion may be useful in the differential diagnosis of tuberculous pleurisy. PATIENTS AND METHODS: We compared the biochemical properties and concentrations of cytokines in serum and pleural effusion samples of 18 patients with tuberculous pleurisy, 7 patients with parapneumonic pleurisy, and 25 patients with malignant pleurisy. RESULTS: A high value of adenosine deaminase (ADA) was observed in pleural effusion of patients with tuberculosis. The serum concentrations of interleukin (IL)-1-beta, IL-2, interferon (IFN)-gamma and tumor necrosis factor (TNF)-alpha were similar among the three groups. However, the concentration of IFN-gamma in pleural effusion was high in tuberculous patients, and that of TNF-alpha was high in tuberculous and parapneumonic pleural fluid, but both cytokines were low in malignant pleural fluid. The sensitivity, specificity and accuracy of IFN-gamma in the diagnosis of tuberculous pleurisy were 94%, 100% and 98%, respectively. Similarly, those of TNF-alpha for the diagnosis of infectious pleurisy including tuberculous and parapneumonic pleurisy were 88%, 80% and 84%, respectively. CONCLUSIONS: Our results indicate that simultaneous measurement of IFN-gamma and TNF-alpha in pleural effusion is a useful diagnostic tool for differentiating tuberculous pleurisy from parapneumonic and malignant pleurisy.
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