USE OF CHOLESTEROL IN THE DIFFERENTIATION OF EXUDATIVE AND TRANSUDATIVE PLEURAL EFFUSION

Light's criteria (protein and LDH) have been used to the present to differentiate exudative pleural effusion from transudative. This is both time consuming and relatively more expensive as compared to measuring cholesterol. During 1992-1993, a prospective study on 70 patients with effusion was carried out measuring fasting LDH, protein, cholesterol, alkaline phosphatase and glucose. All patients had their underlying disease diagnosed then Light's criteria was compared to cholesterol using Wilcoxon's test and Student's t-test. Our findings showed taking a value of pleural cholesterol>55 mg/dL and pleural/serum cholesterol > 0.3 to define exudative effusion resulted in less erroneous classification with a sensitivity of 93%, a specificity of 100%, a positive predictive value (PPV) of 100% and an accuracy of 95.2%. Using Light's criteria gave a sensitivity of 95%, a specificity of 95%, a PPV of 97.6% and an accuracy of 95.2%. Using cholesterol in differentiating exudate from transudate was especially useful in patients with CH.F. who received diuretics. Therefore, using cholesterol to differentiate exudative from transudative pleural effusion is more cost-effective and just as useful as Light's criteria