Role of Pleural Fluid D-Dimer as a Novel Marker in the Diagnosis of Pleural Effusion

Abstract

Introduction: Tuberculous Pleural Effusion (TPE) is associated with enhanced fibrinolytic activity which may lead to high levels of D-dimer. Aim: The present study aimed to investigate whether pleural fluid D-dimer plays a diagnostic role for TPE. Materials and Methods: It is a cross-sectional study comprising of 101 patients diagnosed with pleural effusion that were divided into TPE (41 patients) and Non TPE (60 patients). Pleural D-dimer levels were measured by latex agglutination assay. The capacity of pleural D-dimer to differentiate TPE from non TPE was assessed with Receiver Operating Characteristic (ROC) curve analyses. Results: Subjects with TPE showed a marked elevation of pleural D-dimer than those with Non TPE (Mean: 1690.5 mg/L FEU vs 305 mg/L Fibrinogen Equivalent Unit (FEU); p501 mg/L FEU, the sensitivity and specificity were 90.24% and 86.67%, respectively. Pleural fluid D-dimer levels were higher in TPE as compared to Non TPE. Conclusion: D-dimer might be useful as a novel marker for the diagnosis of TPE.

Keywords

• fibrinolytic activity
• tuberculosis
• sensitivity
• specificity