ArticleBMC pulmonary medicine2023
Conditional diagnostic accuracy according to inflammation status and age for diagnosing tuberculous effusion.
Article in BMC pulmonary medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 5 citations in OpenAlex.
- Development of a diagnostic nomogram for tuberculous pleural effusion.Journal of clinical tuberculosis and other mycobacterial diseases · 2026Article
- A Strong Correlation Between Pleural Fluid and Serum C-Reactive Protein Levels Across a Spectrum of Pleural Effusions.Journal of clinical medicine research · 2026Article
- Differentiating tuberculous pleurisy from pulmonary tuberculosis using mNGS: a multicenter cohort analysis.Frontiers in cellular and infection microbiology · 2026Article
- Diagnostic Efficacy of C-Reactive Protein in Differentiating Various Causes of Exudative Pleural Effusion: Disease Research Should Not Be Exclusive to the Wealthy.Advances in respiratory medicine · 2025Article
- Tired of the confusion around pleural effusions: Adenosine deaminase detection sets the record straight!World journal of clinical cases · 2025Article
- The large language model diagnoses tuberculous pleural effusion in pleural effusion patients through clinical feature landscapes.Respiratory research · 2025Article
- Correction: Conditional diagnostic accuracy according to inflammation status and age for diagnosing tuberculous effusion.BMC pulmonary medicine · 2023Article
Corrections and comments
- Erratum issued
Authors and funding
5 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundTuberculous effusion varies from lymphocyte-dominant to neutrophilic effusion according to inflammation status. The criteria of adenosine deaminase (ADA) and lymphocyte/neutrophil (L/N) ratio have yet not been evaluated across different disease conditions.
methodsPatients who conducted pleural fluid analysis from 2009 to 2019 at Asan Medical Center were included. Criteria (ADA of 50 and L/N ratio of 0.75) were evaluated by quantile subgroups according to age, C-reactive protein (CRP), white blood cell (WBC), and lactate dehydrogenase (LD) by the Monte Carlo simulation method to diagnose tuberculosis. The model for the ADA and L/N ratio was evaluated by AUROC.
resultsAmong the 2,918 reviewed cases, 2034 were included with 229 (11.26%) tuberculosis cases. The mean baseline ADA AUROC was 0.88 across all patients. Increased CRP and WBC showed high proportions of neutrophilic tuberculous effusion, with low sensitivity of approximately 45% and 33% in the fifth WBC and CRP groups, respectively. The AUROC of the models decreased with the increase in WBC and CRP groups (ADA model: 0.69 [the top quantile WBC group], 0.74 [the top quantile CRP group]). The AUROC of the models did not show a trend according to the increase in LD and age.
conclusionInflammatory status affects the diagnostic metrics for tuberculous effusion due to the progression of tuberculous effusion. Clinicians should consider the low accuracy of tuberculous effusion criteria in high-inflammatory conditions when diagnosing tuberculosis.
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