pleural effusion lymphocytosis
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Introduction
Conditions with WBC >= 80% lymphocytes in pleural fluid.
Etiology
- Mycobacterium tuberculosis (tuberculous pleural effusion)
- chylothorax
- lymphoma
- yellow nail syndrome
- rheumatoid arthritis
- CBAG
- sarcoidosis
- acute lung transplant rejection
- uremic pleurisy
Laboratory
- adenosine deaminase in pleural fluid highly specific for tuberculous pleural effusion
- pleural fluid pH < 7.4 & low pleural fluid glucose suggests pleural tuberculosis
Management
- positive tuberculin skin test:
- treat for pulmonary tuberculosis[1]
- negative tuberculin skin test:
More general terms
References
- ↑ 1.0 1.1 Medical Knowledge Self Assessment Program (MKSAP) 11, 14, 15, 16, 17, 18, 19. American College of Physicians, Philadelphia 1998, 2006, 2009, 2012, 2015, 2018, 2021.
Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022 - ↑ 2.0 2.1 NEJM Knowledge+ Question of the Week. June 23, 2020 https://knowledgeplus.nejm.org/question-of-week/566/
Zhou Q et al. Diagnostic accuracy of T-cell interferon-gamma release assays in tuberculous pleurisy: a meta-analysis. Respirology 2011 Feb 9; 16:473 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21299686
Keng LT et al. Evaluating pleural ADA, ADA2, IFN-gamma and IGRA for diagnosing tuberculous pleurisy. J Infect 2013 Jun 26; 67:294 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23796864