A Study on Significance of Serum Effusion Albumin Gradient in The Differential Diagnosis of Pleural Effusion.

ABSTRACT

To evaluate serum pleural effusion albumin gradient (SEAG) as method of differentiating pleural transudates from exudates.Cases admitted in AMCH with diagnosed pleural effusion were divided into 2 groups based on etiology. Group I (transudates) Comprising 14 patients of congestive heart failure (n=6) and nephrotic syndrome (n=3), Cirrhosis (n=4), pericardial effusion (n=1). Group II (exudates) comprising 26 cases of tuberculous (n=15), malignant (n=8) and parapneumonic effusion (n=2), rheumatoid arthritis (n=1). In all patients estimation of pleural fluid to plasma protein ratio, pleural fluid to serum LDH ratio & pleural fluid LDH level, plasma-pleural effusion gradient were evaluated. All these parameters were compared in differentiating pleural transudates from exudates. A total of 40 patients having pleural effusion were divided into 2 groups. Group I (Transudates),Group II (Exudates). Pleural fluid to serum protein of .5 misclassified 20%, pleural fluid LDH OF 200 U/L misclassified 17.5%, pleural fluid LDH to serum LDH misclassified 12.5%, & serum effusion albumin gradient misclassified 5% while differentiating transudates from exudates. Serum pleural effusion albumin gradient (SEAG) is a very useful parameter to differentiate between exudates and transudates esp. in cases misclassified by Light’s criteria.