ARE PLEURAL FLUID PARAMETERS RELATED TO THE DEVELOPMENT OF RESIDUAL PLEURAL THICKENING IN TUBERCULOSIS

Study objective: Identification of predictive factors for the developm ent of residual pleural thickening (RPT). Design: Retrospective study. Location: A 1,500-bed tertiary hospital. Patients: Patients with pleu ral tuberculosis diagnosed between December 1991 and February 1995 in our Respiratory Disease Service. Interventions: The clinical and radio logic characteristics, and measurements of microbiological and biochem ical parameters and markers in pleural fluid were studied. RPT was def ined in a posteroanterior chest radiograph as a pleural space of >2 mm measured in the lower lateral chest at the level of an imaginary line intersecting the diaphragmatic dome. Measurements and results: In 56 patients studied, 11 (19.6%) had RPT 10 mm and 24 (42.8%) had RPT > 2 mm. The pleural fluid of patients with RPT 10 mm had a significantly l ower glucose concentration and pH and higher lysozyme and tumor necros is factor-or levels than the other patients. The pleural fluid of pati ents with RPT >2 mm showed no significant differences. Conclusions: Th e development of RPT 10 mm was related to higher concentrations of lys ozyme and tumor necrosis factor-alpha and lower glucose concentration and pH in pleural fluid compared with development of lower measurement s of RPT.