SUMMARY

t he present study comprised of 40 cases of pleural effusion admitted

in the different medicine units of Assam Medical College &
Hospital during the period of 1 s t June 2003 to 31 s t May 2004. Among
the 40 cases 75% were males & 25% females. The age ranged from 13-
83 years with maximum number of cases in the
3 r d decade.

 Diagnosis of pleural effusion was first made by clinical &

radiological examination of chest & confirmed by aspiration of
pleural fluid.

 Aetiological diagnosis was made by pleural fluid examination for

cytology & culture, histopathological examination of pleural
biops y tissue in selected (i.e. in 11 cases) & other standard
radiological & laborator y procedures.

 Standard methods of estimation of pleural fluid & serum protein,

Lactate Dehydragenase & Albumin were followed.

 Review of relevant literatures were done & revealed that

differential diagnosis of pleural effusions into transudate or
exudate is important & pleural fluid & serum protein estimation
can differentiate 80% of transudates & 82% of exudates with a
misclassification rate of 21%. Pleural fluid LDH estimation can
differentiate 84% of exudates & 82.3% of transudates with total
misclassification of 21.6% while pleural fluid LDH to serum
LDH have a total misclassification rate of 15%. The reviewed
literatures mentioned that Serum-Effusion albumin gradient have
a minimal total misclassification rate around 0-2%.
  SUM M ARY  82

 Results of pleural fluid & serum protein, LDH & Serum-Effusion

albumin gradient were studied & analyzed and compared to the
Etiological diagnosis.

 The parameter of pleural fluid protein> 3g/dl & P/S protein ratio
>0.5 are useful parameters in differential diagnosis & their
combination can differentiate 82% of exudates correctly & 83.3%
transudates correctly with total misclassification of 17.5%.

 The parameter of pleural fluid LDH of 200 U/L can correctly

classif y 83.3% of exudates & 81.25% of transudates with total
misclassification of 17.5%.

 The parameter of P/S LDH of 0.6 correctly classify 88.8% as

exudates & 84.6% transudates with total misclassification of
12.5%.

 Combination of pleural fluid LDH of 200 U/L &P/S LDH of .6

correctly classified 93% of exudates & 88% of transudates with
total misclassification of 10%.

 The parameter of Serum-Effusion albumin gradient of 1.2g/dl

correctly classified 96.15% of exudates & 94% of transudates
with a total misclassification of only 5%.

 The results obtained with the parameter of protein, LDH in

pleural fluid & serum are found to be suitable parameters, but the
Serum-Effusion albumin gradient of 1.2 g/dl has the highest
differentiating ability with a sensitivity and specificity of 96.1%
& 93% with total misclassification of only 5%.

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