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Original Research



Etiology and clinical profile of pleural effusion

Malay Kumar Maikap, Aparup Dhua, Malay Kumar Maitra.




Abstract

Background: Pleural effusion is an excessive or abnormal collection of fluid in pleural space. Etiological study of pleural effusions is challenging to the physician as it differs depending on the region where the study is being carried out and the population involved.

Objective: In this study, we aimed to identify the common etiologies causing pleural effusion and their clinical profile in a teaching institution.

Materials and Methods: It was a prospective evaluation of 250 consecutive cases of pleural effusion. Detailed history and physical examination, pleurocentesis and pleural fluid analysis were done in all cases and closed pleural biopsy, computed tomography (CT), fiber-optic bronchoscopy, and other relevant examination in selected cases.

Results: The most common cause pleural effusion in this study was tuberculosis (68.8%), followed by malignancy (14%), empyema (6%), and transudative effusion (2.8%). Pleural effusion was commonly seen in male (66%). The occurrence of tubercular pleural effusion was maximum in the age group 21–30 years, but malignant pleural effusion was more common above 60 years of age. Right-sided effusions were more common. Estimation of pleural fluid adenosine deaminase plays a significant role in the diagnosis of tubercular pleural effusion. Pleural fluid cytology and closed pleural biopsy can diagnose most of the cases of pleural effusion due to malignancy.

Conclusion: The etiological diagnosis of pleural effusion remains unchanged even after few decades in our country. Even after thorough investigations with the help of closed pleural biopsy, fiber optic bronchoscopy, CT scan and CT guided fine needle aspiration cytology and others, 5.2% of cases could not be diagnosed. It has been also observed in another study where 15% cases remain undiagnosed. Thoracoscopic pleural biopsy may narrow down this gap.

Key words: Pleural Effusion; Tubercular Pleural Effusion; Pleural Biopsy






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