There has been considerable recent interest in the potential use of serum cystatin C as a diagnostic tool. Here we examined the hypothesis that the cystatin C level in the pleural effusion can differ from the corresponding serum level. We evacuated pleural effusion fluids from 47 patients by thoracentesis. Cystatin C, β2-microglobulin, inorganic phosphate, creatinine and total protein were quantified in both pleural effusion fluids and corresponding sera. We determined cystatin C levels in pleural effusions and calculated the ratio of cystatin C levels in serum and effusion, to discriminate between effusions caused by severe renal impairment and other types of effusion. Extremely high concentrations of cystatin C in serum/effusion pairs were only measured in patients with renal failure (6.0±0.8/6.0±0.8mg/l, means±S.D., n = 11). A clearly defined region was found to correspond to pleural effusion caused by renal failure (r = 0.954). The quantification of cystatin C in the effusion was justified by the discovery that there were some patients with a high serum cystatin C level but a low effusion concentration, or a low serum cystatin C but a high effusion concentration, indicating causes other than renal failure. In conclusion, the pilot data indicate a relationship between the cystatin C concentration in pleural fluid and the underlying disease. Thus cystatin C levels in pleural effusion and serum may be a valuable criterion for the differential diagnosis of pleural diseases of different aetiologies.
Cystatin C of pleural effusion as a novel diagnostic aid in pleural diseases of different aetiologies
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Wolfgang DOMEJ, Gernot Peter TILZ, Zeno FÖLDES-PAPP, Ulrike DEMEL, Thomas RABOLD, Herwig HOLZER; Cystatin C of pleural effusion as a novel diagnostic aid in pleural diseases of different aetiologies. Clin Sci (Lond) 1 March 2002; 102 (3): 373–380. doi: https://doi.org/10.1042/cs1020373
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