AI Article Synopsis
- The study evaluated the diagnostic potential of pleural fluid complement levels (total, C3, C4) in 135 patients with pleural effusion from five main causes.
- Complement levels were found to correlate with other fluid markers, and lower C4 levels were particularly notable in congestive heart failure (CHF) cases compared to postsurgical or parapneumonic effusions.
- While overall diagnostic accuracy was low, pleural fluid C4 levels were effective in distinguishing CHF-related effusions, suggesting that normal C3 or C4 levels can help rule out CHF or lung transplant (LTX) as causes of pleural effusion.
Article Abstract
We prospectively assessed the diagnostic value of pleural fluid complement levels (total, C3, C4) in 135 patients with pleural effusion of five main etiologies, using novel markers. Complement levels correlated with pleural levels of protein, amylase, and transuded fluids. On univariate analysis, CHF-related pleural effusions were associated with significantly lower C4 levels than postsurgery or parapneumonic effusions. On multivariate analysis, pleural fluid C4 level was a significant predictor of CHF. Although the specificity, positive predictive value, and accuracy of the parameters were low in all diagnostic groups, their negative predictive value as well as the AUC ROC was high for CHF and post-LTX. We conclude that pleural fluid C4 levels can differentiate CHF-related pleural effusion from other etiologies and that normal level of C3 or C4 rule out CHF or LTX as causes of pleural effusion. Complement should be included in the assessment of pleural effusion when traditional diagnostic methods fail.
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| http://dx.doi.org/10.1016/j.rmed.2008.05.008 | DOI Listing |
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