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<strong>Chest</strong> & <strong>Heart</strong> JournalVol. <strong>35</strong>, <strong>No</strong>. 2, July <strong>2011</strong>ORIGINAL ARTICLEAssessment <strong>of</strong> Diagnostic Value <strong>of</strong> C-ReactiveProtein in Granulomatous PleuritisSaroj Kanti Chowdhury 1 , Taposh Bose 1 , Md. Khairul Anam 2 , Nihar Ranjan Saha 2 ,Md. Sirajul Islam 3 , Bipul Kanti Biswas 3 , Mohammed Shahedur Rahaman Khan 4 ,Biswas Akhtar Hossain 4 , K.C Ganguly 4 , S.M.Abdur Razzaque 4 , AKM Mustafa Hussain 5 ,Mirza Mohammad Hiron 6Abstract:Background: Tuberculosis is an ancient human disease. <strong>The</strong> determination <strong>of</strong>biological marker levels in pleural effusions has been proposed as an alternativenoninvasive means <strong>of</strong> establishing a diagnosis <strong>of</strong> granulomatous pleuritis . Avariety <strong>of</strong> biological markers have been proposed to facilitate differential diagnosis<strong>of</strong> granulomatous pleuritis, C-reactive protein (CRP) is one <strong>of</strong> them. <strong>The</strong> presentstudy was conducted to find out the sensitivity, specificity, accuracy, positive<strong>and</strong> negative predictive value <strong>of</strong> CRP for diagnosis <strong>of</strong> granulomatous pleuritis.Method: <strong>The</strong> study was a cross sectional study conducted for one year fromJanuary 2010 to December 2010 in the Department <strong>of</strong> Respiratory Medicine,National Institute <strong>of</strong> Diseases <strong>of</strong> the <strong>Chest</strong> <strong>and</strong> Hospital, Mohakhali, Dhaka.Total 103 patients with clinically <strong>and</strong> radiologically diagnosed pleural effusionwere included in the study. All patients <strong>of</strong> 18-80 years <strong>of</strong> age <strong>and</strong> both sexes withpleural effusion who were admitted during the study period in NIDCH <strong>and</strong>subsequently undergone thoracentesis were included in the present study throughpurposive sampling following inclusion <strong>and</strong> exclusion criteria.Result: In the present study mean ± SD <strong>of</strong> age <strong>of</strong> the patient was 50.24 ± 18.38years. Out <strong>of</strong> 103 cases <strong>of</strong> pleural effusion cases 50 (48.5%) were granulomatouspleuritis 8 them 46 were CRP +ve & 4 were CRP -ve <strong>and</strong> another 50 (48.5%) caseswere caused by malignancy. Rheumatoid arthritis, nephrotic syndrome <strong>and</strong>congestive cardiac failure were found as the causes <strong>of</strong> pleural effusion one in each(1.0%) at cut <strong>of</strong> value 8.48. Sensitivity, specificity, PPV, NPV <strong>and</strong> accuracy <strong>of</strong> C -reactive protein in the diagnosis <strong>of</strong> granulomatous pleuritis were 92.0%, 90.6%,90.2%, 92.3% <strong>and</strong> 91.3% respectively. Positive Likelihood Ratio was 9.752 <strong>and</strong>Negative Likelihood Ratio was 0.088.Conclusion: <strong>The</strong> result indicated that the analysis <strong>of</strong> C - reactive protein levels inpleural fluid constitute a very useful marker for the diagnosis <strong>of</strong> granulomatous pleuritiswhich, in addition, can be made quickly <strong>and</strong> cheaply. So, we may conclude that overallthis test is a very helpful adjunct test for the diagnosis <strong>of</strong> granulomatous pleuritis.[<strong>Chest</strong> & <strong>Heart</strong> Journal <strong>2011</strong>; <strong>35</strong>(2) : 77-85]1. Emergency Medical Officer, National Institute <strong>of</strong> Diseases <strong>of</strong> the <strong>Chest</strong> <strong>and</strong> Hospital, Mohakhali, Dhaka.2. Registrar (Respiratory Medicine), National Institute <strong>of</strong> Diseases <strong>of</strong> the <strong>Chest</strong> <strong>and</strong> Hospital, Mohakhali, Dhaka.3. RMO, NIDCH4. Assistant Pr<strong>of</strong>essor (Respiratory Medicine), National Institute <strong>of</strong> Diseases <strong>of</strong> the <strong>Chest</strong> <strong>and</strong> Hospital,Mohakhali, Dhaka.5. Associate Pr<strong>of</strong>essor (Respiratory Medicine) & Director, National Institute <strong>of</strong> Diseases <strong>of</strong> the <strong>Chest</strong> <strong>and</strong> Hospital,Mohakhali, Dhaka.6. Pr<strong>of</strong>essor (Respiratory Medicine) & Former Director, National Institute <strong>of</strong> Diseases <strong>of</strong> the <strong>Chest</strong> <strong>and</strong> Hospital,Mohakhali, Dhaka.Correspondence to: Emergency Medical Officer, National Institute <strong>of</strong> Diseases <strong>of</strong> the <strong>Chest</strong> <strong>and</strong> Hospital,Mohakhali, Dhaka, Email – sarojcdr@yahoo.com
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