COMPARATIVE-ANALYSIS OF BIOCHEMICAL PARAMETERS FOR DIFFERENTIATION OFPLEURAL EXUDATES FROM TRANSUDATES LIGHTS CRITERIA, CHOLESTEROL, BILIRUBIN, ALBUMIN GRADIENT, ALKALINE-PHOSPHATASE, CREATINE-KINASE, AND URIC-ACID

The differentiation of pleural effusions as being either transudate or exudate is the first step in the diagnosis of pleural effusions. The aim of this study was to compare the efficiency of the various biochem ical parameters to the traditional criteria of Light et al., for diffe rentiating exudates from transudates. Ninety-three pleural fluid and s era specimens were obtained and classified as transudates or exudates on the basis of their diagnosis. Of the 93 pleural fluids, 21 were tra nsudates, 72 were exudates. The efficiencies of different parameters f or detection of exudates were as follows: The criteria of Light 96%; e ffusion cholesterol concentration 77%; serum-fluid albumin gradient 67 %, pleural/serum alkaline phosphatase ratio 83%; effusion creatine kin ase levels 91%; pleural/serum creatine kinase ratio 83%, and effusion uric acid 71%. Pleural/serum uric acid ratio was insignificant for the purpose of this study. (C) 1997 Elsevier Science B.V.