Overview
Pleurisy without effusion refers to inflammation of the pleura without the accumulation of excess fluid in the pleural space. Diagnosis can be challenging, particularly in differentiating it from other inflammatory conditions.Diagnosis
Diagnosis of tuberculous pleurisy (TP) is challenging 1.
Pleural fluid interferon gamma release assay (PF-IGRA) has important diagnostic value in TP 1.
A meta-analysis of 26 publications including 30 case-control studies found pooled sensitivity of 0.90 (0.88-0.91) and specificity of 0.87 (0.85-0.89) for PF-IGRA in diagnosing TP 1.
The positive likelihood ratio (PLR) was 7.64 (4.46-13.07) and the negative likelihood ratio (NLR) was 0.13 (0.09-0.19) 1.
The area under the summary receiver operating characteristic (SROC) curve (AUC) was 0.9508 1.
Sensitivity, specificity, and AUC of PF-IGRA for TP were higher in areas with a high tuberculosis burden compared to areas with a low tuberculosis burden 1.Management
No specific management strategies for pleurisy without effusion or active tuberculosis were detailed in the provided abstracts.Key Recommendations
Pleural fluid interferon gamma release assay (PF-IGRA) is a valuable diagnostic tool for tuberculous pleurisy 1. (Evidence: Strong)
The diagnostic performance of PF-IGRA for tuberculous pleurisy is influenced by the local tuberculosis burden, with higher sensitivity and specificity observed in high-burden areas 1. (Evidence: Moderate)
When considering PF-IGRA for tuberculous pleurisy, the enzyme-linked immunosorbent assay (ELISA) method may offer higher sensitivity than other IGRA methods, with similar specificity 1. (Evidence: Moderate)References
1 Tong X, Li Z, Zhao J, Liu S, Fan H. The value of single or combined use of pleural fluid interferon gamma release assay in the diagnosis of tuberculous pleurisy. Tropical medicine & international health : TM & IH 2021. link