The value of use of amino-terminal brain naturitic peptide as marker in cases of pleural effusion of different etiologies

Abstract Background The criteria of Light et al. have been used to make the differentiation between transudate and exudate effusion for the past 25 years. The main problem with those criteria is that although they identify nearly all exudates correctly, they misidentify about 20–25% of transudates as exudates. The plasma NT-proBNP level is a sensitive marker of cardiac dysfunction and has proved to be a useful tool for the identification and management of systolic and diastolic cardiac dysfunction. Objective The aim of this work was to study the value of pleural NT-pro brain natriuretic peptide in the diagnosis of pleural effusion of different causes in comparison to the conventional diagnostic procedures in cases of pleural effusion. Subjects and methods The present study was conducted on 32 patients who suffered from pleural effusion, they were classified according to Light’s criteria into two groups namely transudate, exudate, and the third group of 10 normal healthy subjects as control group. Results The levels of both serum and pleural fluid pro-BNP in group I patients with transudate effusion were significantly higher than group II patients with exudate effusion ( P  > 0.001, 0.003) respectively. Conclusion The results support the feasibility of using the pleural fluid amino terminal proBNP measurement in thoracentesis that would enhance discrimination among the different causes of pleural effusion especially for heart failure patients. Serum and pleural fluid levels of NT-pro BNP were closely correlated and measurement of NT-pro BNP in serum showed equally good diagnostic properties.