The Use of Pleural Fluid to Serum Glucose Ratio in Establishing the Diagnosis of a Not So Sweet PD-Related Hydrothorax: Case Report and Literature Review
Joint Authors
Sullivan, Abigayle
Bohra, Nidrit
Chaudhary, Haseeb
Demko, Trudy
Source
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-09-07
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
Hydrothorax is a well-known but rare complication of peritoneal dialysis (PD), with an average incidence of 2% mainly in cases of continuous ambulatory peritoneal dialysis (CAPD).
In more than 80% of these cases, the hydrothorax is attributed to an abnormal pleuroperitoneal communication.
It commonly manifests as unilateral effusion, predominantly on the right.
A thoracentesis to determine pleural glucose has been a diagnostic aid well relied on, as the dextrose rich dialysate raises the pleural fluid glucose.
A pleural fluid glucose to serum glucose gradient greater than 50 mg/dL is suggestive of a leak with a specificity of 100% according to some studies; however, its sensitivity is variable.
Our case illustrates a diagnostic dilemma due to a relatively low pleural fluid to serum glucose gradient of 21 mg/dL that caused a delay in diagnosis.
A pleural fluid to serum glucose ratio >1.0 was used as a diagnostic marker that pointed toward a peritoneal leak.
For confirmation, a peritoneal scintigraphy with nuclear technetium 99 scan was performed that revealed a pleuroperitoneal fistula as the source of the recurring hydrothorax in the setting of automated peritoneal dialysis (APD).
The hydrothorax completely resolved with termination of APD on follow-up as the patient was transitioned to intermittent hemodialysis (HD).
American Psychological Association (APA)
Bohra, Nidrit& Sullivan, Abigayle& Chaudhary, Haseeb& Demko, Trudy. 2020. The Use of Pleural Fluid to Serum Glucose Ratio in Establishing the Diagnosis of a Not So Sweet PD-Related Hydrothorax: Case Report and Literature Review. Case Reports in Nephrology،Vol. 2020, no. 2020, pp.1-4.
https://search.emarefa.net/detail/BIM-1148804
Modern Language Association (MLA)
Sullivan, Abigayle…[et al.]. The Use of Pleural Fluid to Serum Glucose Ratio in Establishing the Diagnosis of a Not So Sweet PD-Related Hydrothorax: Case Report and Literature Review. Case Reports in Nephrology No. 2020 (2020), pp.1-4.
https://search.emarefa.net/detail/BIM-1148804
American Medical Association (AMA)
Bohra, Nidrit& Sullivan, Abigayle& Chaudhary, Haseeb& Demko, Trudy. The Use of Pleural Fluid to Serum Glucose Ratio in Establishing the Diagnosis of a Not So Sweet PD-Related Hydrothorax: Case Report and Literature Review. Case Reports in Nephrology. 2020. Vol. 2020, no. 2020, pp.1-4.
https://search.emarefa.net/detail/BIM-1148804
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1148804