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Chung, Park, Kim, Chang, Chung, Kim, and Kim: Pleural Fluid Analysis in Tuberculous Pleurisy Progressing into Severe Pleural Thickening Underwent Pleural Decortication
Original Article

Tuberculosis and Respiratory Diseases 2003; 55(4): 353-360.

Published online: 31 October 2003

DOI: https://doi.org/10.4046/trd.2003.55.4.353

Pleural Fluid Analysis in Tuberculous Pleurisy Progressing into Severe Pleural Thickening Underwent Pleural Decortication

Jae Ho Chung, M.D.1, Moo Suk Park, M.D.1, Se Kyu Kim, M.D.1, 3, 4, Joon Chang, M.D.1, 3, Kyung Young Chung, M.D.2, 3, Sung Kyu Kim, M.D.1, 3, Young Sam Kim, M.D.1, 3

1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

2Department of Cardiovascular and Thoracic Surgery, Yonsei University College of Medicine, Seoul, Korea.

3The Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea.

4Brain Korea 21 Project for Medical Sciences, Yonsei University College of Medicine, Seoul, Korea.

Address for correspondence: Young Sam Kim, M.D. Department of Internal Medicine, Yonsei University College of Medicine, CPO Box 8044, Seoul, Korea. Phone: 82-2-361-5394, Fax: 82-2-393-6884, ysamkim@yumc.yonsei.ac.kr

Copyright©2003. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Background

Although most patients with tuberculous pleurisy respond well to anti-tuberculous drugs, some are known to progress into severe pleural thickening which needs decortication despite adequate anti-tuberculous treatment. Therefore, the purpose of this study was to identify factors associated with the development of severe pleural thickening in patients who finally underwent pleural decortication in tuberculous pleurisy.

Patients and Methods

From retrospective medical records review, 121 patients initially diagnosed as tuberculous pleurisy without initial pleural fluid loculation were enrolled between January 1998 and December 2002. They were separated into two groups: 85 patients in group 1 who improved by anti-tuberculous drugs only, and 36 patients in group 2 who had progressed into pleural adhesion and finally underwent pleural decortication despite adequate (more than 6 months) anti-tuberculous treatment.

Results

Males were more common in group 2 (M/F=31/5) than in group 1 (M/F=53/32) (p=0.010). Group 2 patients tended to have lower pleural fluid glucose level (58±4 mg/dL) than group 1 (89±3 mg/dL) (p=0.001) and higher pleural fluid adenosine deaminase level (86±5 IU/L) than group 1 (76±3IU/L), (p=0.038). There were no significant differences in age, symptom duration, pleural fluid amount, or pleural fluid LDH level between groups 1 and 2.

Conclusions

There was a relative risk of tuberculous pleurisy progression into severe pleural thickening which needed decortication in the case of male patients, low pleural fluid glucose or high adenosine deaminase level. But further, large-scale, prospective studies should be investigated.

Keywords: Pleural thickening, Tuberculous pleurisy, Pleural Decortication

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