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Pleural-fluid myeloperoxidase in complicated and noncomplicated parapneumonic pleural effusions

Depts of ¹ Internal Medicine, ² Biochemistry, ³ Microbiology, ⁴ Preventive Medicine and Epidemiology, Vall d'Hebron General Hospital, Barcelona, Spain

CORRESPONDENCE: J. Alegre, Juan de Garay 19, 3° 1a, 08041, Barcelona, Spain. Fax: 34 32844234. E-mail: 18502jam@comb.es

Keywords: myeloperoxidase, parapneumonic pleural effusions

Received: June 13, 2000
Accepted September 5, 2001

This work was financed in part by a Fondo de Investigacion Sanitaria grant (96/0977).

The diagnostic accuracy of myeloperoxidase (MPO) in pleural fluid, for differentiating between complicated and noncomplicated parapneumonic pleural effusions (PPE) evaluated prospectively.

Seventy patients aged >18 yrs with PPE (36 complicated and 34 noncomplicated) were studied after admission to a tertiary referral teaching hospital. MPO concentration was measured in plasma and pleural fluid using a double-antibody competitive radioimmunoassay.

The concentrations of MPO in complicated and noncomplicated PPE were compared using a Mann-Whitney U-test and multiple logistic regression models were used to predict the odds that an effusion was complicated. MPO pleural-fluid concentrations were significantly higher in complicated than in noncomplicated PPE. After excluding purulent effusions, pleural-fluid MPO was the marker that best differentiated between the two types of PPE: the area under the receiver operating characteristic curve was 0.912, the sensitivity was 87.5% and the specificity was 85.1% at a cut-point limit of 3.000 µg·L^–1.

The authors concluded that the concentration of pleural-fluid myeloperoxidase helps to differentiate between nonpurulent complicated and noncomplicated parapneumonic pleural effusions.

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