RT Journal Article
SR Electronic
T1 Procalcitonin in pleural fluid: A new tool for the diagnosis of empyema and parapneumonic pleural effusions?
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p2504
VO 38
IS Suppl 55
A1 Estelle Hoguet
A1 Claire Andrejak
A1 Anne Marie Bourgeois
A1 Charles Dayen
A1 Vincent Jounieaux
A1 Youcef Douadi
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p2504.abstract
AB Background: Few data are available about the usefulness of procalcitonin (PCT) measurement in pleural effusions. Results are controversial with 3 studies with negative results and 2 with promising results in parapneumonic pleural effusions. No study has assessed the value of PCT in pleural liquid.Methods: We conducted a study to assess the reliability and the reproducibility of PCT measurements in pleural fluid and to determinate its performance for the diagnosis of parapneumonic pleural effusions through ROC curves.Results: We measured PCT in the pleural liquid of 35 patients (550 mesures) with pleural effusion (3 transudates in acute heart failure, 13 metastatic pleural effusion, 17 empyema and parapneumonic effusion and 2 exudates due to an other cause). PCT values were low in 16 cases (< 0.18 ng/ml), medium in 10 cases (between 0.18 and 1 ng/ml) and high in 9 cases (> 1 ng/ml). Reliability: thirty consecutive measurements of the same sample showed a low variation coefficient (< 4%) for medium and high PCT values. A similar variation coefficient was found when PCT was tested in blood. Reproducibility: samples were also kept at 4°C and were tested every day during 5 days with a variation coefficient less than 5% for medium and high PCT values, and less than 4% for the first 3 days. For the diagnosis of empyema or parapneumonic pleural effusions, the ROC curve determined a 0.183 ng/ml PCT cut-off, with a 80% sensitivity and specificity.Conclusion: PCT could be considered as a useful tool in diagnosis of empyema and parapneumonic pleural effusion with a 80% sensitivity and specificity for a 0.183 ng/ml cut-off. Furthers studies are required to confirm these data.