New diagnostic opportunities when testing biological materials from those with pleural effusion caused by tuberculosis

The objective of the study: to evaluate the opportunity of using molecular genetic tests to diagnose exudative pleurisy caused by tuberculosis.

Subjects and methods. 98 patients with pleural effusion were examined. 38 patients were diagnosed with pleurisy caused by tuberculosis, 38 patients suffered from non-specific pleurisy, and in 16 patients pleurisy was caused by tumors.

Results. In case of pleural effusion caused by tuberculosis, the classic criteria of exudate (Rivalta test, the ratio of pleural fluid protein and blood serum protein) were not informative. Thus, the result of Rivalta test was positive only in 33.3%, the mean ratio of pleural fluid protein and blood serum protein made only 0.32 ± 0.09. It was found out that the level of lactic dehydrogenase above 1,000 u/l, and the ratio of lactic dehydrogenase level in pleural fluid and its level in blood serum above 3, were rather typical of pleural effusion caused by tuberculosis. And the level of adenosine deaminase in plural fluid above 50 u/l was also more typical of tuberculous pleural effusion. When testing pleural fluid as a diagnostic material, the poor sensitivity was demonstrated by various microbiological tests (the maximum sensitivity did not exceed 42.1%). The most informative and rapid methods aimed at detection and deciding on the treatment tactics included integral morphological and molecular genetic (GeneXpert MTB/Rif) tests of parietal pleural specimens.

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