TO STUDY THE VARIOUS ETIOLOGIES OF PLEURAL EFFUSION

Abstract

BACKGROUND: Pleural effusion is the abnormal collection of fluid in thepleural space. The etiological spectrum of pleural effusion depends on thegeographical location and local incidence of different diseases that cause1,2 pleural effusions. In developed countries the most common causes of pleuraleffusion are cardiac failure, malignancy and pneumonia whereas in developing3-5 countries, tuberculosis and para pneumonic effusion are more prevalent.OBJECTIVE: To study the various etiologies of pleural effusions in a tertiarycare hospital of Pakistan.METHODOLOGY: This was a prospective study of 4 months duration, carriedout in the Department of Pulmonology, Liaquat National Hospital Karachi fromthe period September 2013 to December 2013. This study included all patients>15 years age who were admitted in chest unit or visited chest medicineOutdoor Department (OPD). Clinical records of the patients were reviewed forrisk factors, more than 90% patients underwent thoracocentesis in whichpleural fluid was aspirated and sent for biochemical, cytological and microbiologicalstudies and additional clinical and radiological examinations wereperformed.RESULTS: During the study period, total 70 cases of pleural effusions wereidentified;. There were 45 males (64.28%) and 25 females (35.71%) having amean age of 54 years. Pleural effusion was exudative in 45 (64.28%) andtransudative in 21 cases (30%) (total 70: also give characteristics of remaining4 patients: borderline, empyema or hemorrhagic etc). Radiological resultsshowed right sided pleural effusion in 33 (47.14%), left sided in 12 (17.14%),and bilateral pleural effusions in 21 cases (30%). The most frequent cause ofpleural effusion was tuberculosis in 29 cases (42%), malignancy in 13 (18%),Congestive heart failure (CCF) in 10 (14%), pneumonia in 06 (08%), Chronicliver disease (CLD) in 04 (06%), Chronic Kidney Disease (CKD) with liverabscess, sepsis & pneumonia in 04 cases (06%) similar problem, trauma in 01case (1.42%); while 04 cases remained undiagnosed (06%) and expired duringthe study period.CONCLUSION: Our study confirms Tuberculosis being the most commoncause of exudative pleural effusions while CCF remains the most commoncause of a transudative pleural effusion in patients coming to Liaquat NationalHospital Karachi.