Clinical and pathological differences between polymorphonuclear-rich and lymphocyte-rich tuberculous pleural effusion
| العنوان: | Clinical and pathological differences between polymorphonuclear-rich and lymphocyte-rich tuberculous pleural effusion |
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| المؤلفون: | Yurong Xu, Bing Chen, Yiqing Qu, Tingting Zhao |
| المصدر: | Annals of Thoracic Medicine Annals of Thoracic Medicine, Vol 15, Iss 2, Pp 76-83 (2020) |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Pulmonary and Respiratory Medicine, medicine.medical_specialty, lcsh:Diseases of the circulatory (Cardiovascular) system, Pleural effusion, tuberculous granuloma, medicine.medical_treatment, Lymphocyte, thoracoscopy, Gastroenterology, Mycobacterium tuberculosis, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, tuberculous pleural effusions, Internal medicine, Lactate dehydrogenase, Biopsy, medicine, Thoracoscopy, 030212 general & internal medicine, lcsh:RC705-779, biology, medicine.diagnostic_test, business.industry, lactate dehydrogenase, lcsh:Diseases of the respiratory system, Decortication, biology.organism_classification, medicine.disease, medicine.anatomical_structure, Adenosine deaminase, 030228 respiratory system, chemistry, Effusion, lcsh:RC666-701, Surgery, Original Article, Cardiology and Cardiovascular Medicine, business |
| الوصف: | OBJECTIVE: Analysis of the occurrence factors and disease characteristics of tuberculous (TB) pleural effusion (TPE) dominated by neutrophils. METHODS: We retrospectively analyzed the clinical data of 304 patients with two types of TB pleurisy. The clinical, laboratory, and pathological features of TB pleurisy separately dominated by lymphocytes and neutrophils were analyzed. RESULTS: Neutrophil-predominant effusion was observed in 33 (10.9%) patients. The patients with TPE with polymorphonuclear leukocytes (PMNLs) had higher fever rates and higher decortication rates than those with lymphocyte-predominant TPE. Otherwise, they had lower chest distress rates and lower positive rates of pulmonary TB and lower biopsy tissue culture-positive rates than patients with lymphocyte-predominant TPE. PMNL TPE patients had higher lactic acid dehydrogenase (LDH) (1297 vs. 410 U/l, P < 0.001) and adenosine deaminase (ADA) levels (54.1 vs. 42.9 U/l, P = 0.043) and lower pleural fluid glucose (1.92 vs. 4.70 mmol/L, P < 0.001) and protein (47.4 vs. 48.4 g/L, P = 0.024) levels than that of lymphocyte-predominant TPE. Otherwise, they had lower blood ALB levels and higher C-reactive protein levels than lymphocyte-predominant TPE. Finally, PMNL TPE patients had lower rates of granuloma formation (27.2% vs. 75.2%, P < 0.001) and pleural nodules than patients with lymphocyte-predominant TPE and more frequent findings of pus, caseous exudate, and necrosis. CONCLUSION: The TB pleurisy patients dominated by neutrophils show strong inflammatory reactions and higher ADA levels in pleural effusion. These findings can significantly improve the positive rate of Mycobacterium tuberculosis in neutrophil-predominant TPE under thoracoscopy. |
| تدمد: | 1817-1737 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f66b67b37a9f62f1e8450e9768caf086Test https://pubmed.ncbi.nlm.nih.gov/32489442Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....f66b67b37a9f62f1e8450e9768caf086 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 18171737 |
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