DIAGNOSTIC VALUE OF URIC ACID IN PLEURAL EFFUSION

Authors

  • Saraswati Wulandari Hartono Department of Clinical Pathology, Faculty of Medicine, Hasanuddin University/Wahidin Sudihusodo Hospital, Makassar, Indonesia
  • Nurhayana Sennang Department of Clinical Pathology, Faculty of Medicine, Hasanuddin University/Wahidin Sudihusodo Hospital, Makassar, Indonesia
  • Fitriani Mangarengi Department of Clinical Pathology, Faculty of Medicine, Hasanuddin University/Syekh Yusuf Hospital, Gowa, Indonesia

DOI:

https://doi.org/10.24293/ijcpml.v24i2.1314

Keywords:

Uric acid, pleural effusion, Light's criteria

Abstract

Pleural effusion is excessive pleural fluid accumulation in the aimed pleural cavity, are categorized into exudate and transudate. Light's criteria (1972) has become a classic criteria to distinguish pleural effusion types. Other criteria were evaluated such as pleural fluid uric acid. The aimed of this study was to analyze the difference of uric acid level between transudate and exudate and to compare it with Light's criteria. A cross-sectional study was conducted in Clinical Pathology Laboratory of the Dr. Wahidin Sudirohusodo Hospital Makassar in September 2016. Uric acid level of pleural effusion samples was measured by ABX Pentra 400. Statistical analysis used Mann-Whitney U test, significance was indicated if p<0.05. Cut-off, sensitivity and specificity of uric acid used ROC curve. Total subjects were 56 patients, mean age 49.54+13.63 years-old, 31 males (55.4%) and 25 females (44.6%). Most cases were exudative effusion (58.9%) with 19 malignancy cases (33.9%). Uric acid level median was 6.6 mg/dL (3.24-17.50 mg/dL) higher in transudate than exudate 5.01 mg/dL (0.6-9.40 mg/dL) (p=0.001). The cut-off point for pleural fluid uric acid was 5.845 mg/dL, with a sensitivity of 78.3% and specificity of 66.7%. Sensitivity and specificity of Light's criteria was 97% and 60.9%. There was a significant difference between pleural fluid uric acid level in transudate and exudate, higher in transudate than exudate. Light's criteria were higher in sensitivity than uric acid, but lower in specificity. Further research is needed with better sampling method to reduce bias.

 

Downloads

Download data is not yet available.

References

Nurahmi, Wibawa SY, Badji A, Hardjoeno. Tes dan Interpretasi Pleural fluid. Dalam: Hardjoeno, Fitriani, editors. Substansi dan Cairan Tubuh. Makassar, Lembaga Penerbitantan Universitas Hasanuddin, 2011; 67-84.

Jain A, Jain R, Petkar SB, Gupta SK, Khare N, Dutta J. A Study of Uric Acid - A New Biochemical Marker for The Differentiation between Exudates and Transudates in Pleural Effusion Cases. NJCM. 2014; 5(2): 204-8.

Rubins J. Pleural Effusion. 2014 [accesed September 4, 2014]; Available from: http://emedicine.medscape.com/article/299959-overview#showall.

Sato T. Differential Diagnosis of Pleural Effusions. JMAJ. 2006; 49(9-10): 315-9.

Hazarika B, Raghavendra MK, Sarma J, Sarmah KR. Role of Pleural Fluid Uric Acid Estimation In Differentiation Between Transudative and Exudative Pleural Effusion. The Pulmo-Face. 2015; 15(2): 55-60.

Wilson DD. Uric Acid, Blood. Manual of Laboratory and Diagnostic Tests. Illinois, McGraw-Hill, 2006; 579-80.

Uzun K, Vural H, Ozer F, Imecik O. Diagnostic Value of Uric Acid to Differentiate Transudates and Exudates. Clin Chem Lab Med. 2000; 38(7): 661-5.

National Center for Biotechnology Information. PubChem Compound Database CID1175; [accessed June 15, 2016]; Available from: https://pubchem.ncbi.nlm.nih.gov/compound/1175.

Light RW. Disorders of The Pleura and Mediastinum. In: Loscalzo J, editor. Harrisons's Pulmonary and Critical Care Medicine. 17th Ed., San Fransisco, McGraw Hill Medical, 2010; 215-9.

Porcel JM. Identifying misclassified by Light's criteria. Curr Opin Pulm Med. 2013; 19(4): 362-367.

Surjanto E, Sutanto YS, Aphridasari J, Leonardo. Penyebab Efusi Pleura pada Pasien Rawat Inap di Rumah Sakit. J Respir Indo. 2014; 34(2): 102-8.

Alfakir M, Moammar MQ, Ali MI, Alhatem E, Curran RD, Saoud RM, et al. Pulmonary Gas Exchange During Hemodialysis: A Comparison of Subjects with and without COPD on Bicarbonate Hemodialysis. Ann Clin Lab Sci. 2011; 41(4): 315-20.

Li S, Tan HY, Wang N, Zhang ZJ, Lao L, Wong CW, et al. The Role of Oxidative Stress and Antioxidants in Liver Diseases. Int J Mol Sci. 2015; 16(11): 26087-90.

Downloads

Submitted

2018-09-30

Accepted

2018-09-30

Published

2018-09-30

How to Cite

[1]
Hartono, S.W., Sennang, N. and Mangarengi, F. 2018. DIAGNOSTIC VALUE OF URIC ACID IN PLEURAL EFFUSION. INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY. 24, 2 (Sep. 2018), 146–150. DOI:https://doi.org/10.24293/ijcpml.v24i2.1314.

Issue

Section

Articles