Estimation of Serum and Pleural Fluid Amylase in HIV Seronegative Patients with Tuberculous Pleural Effusion and Its Implication in The Diagnosis of Tubercular Pleural Effusion

Abstract

Introduction: To estimate enzyme amylase levels in Serum and pleural fluids of HIV seronegative exudative tuberculous pleural fluids and their feasible position within the prognosis of tubercular pleural effusion. Methods & Materials: A Prospective study was done at Dept. of Biochemistry, North Bengal Medical College and Hospital, Sirajganj, Bangladesh from March 2022 to May 2023 after taking institutional ethical committee approval on exudative pleural effusion samples for detection of Tuberculosis by estimating amylase in serum and pleural fluid. A total of 100 patients were selected for this study. The selected individuals were randomly enrolled as cases and controls for this study, with 50 participants each. Amylase in blood and pleural fluid samples was tested using the CNPG method within the designated time on the same day to prevent loss of analytes. Results: Total 100 patients were enrolled, including 50 cases of tuberculous pleural effusion and 50 controls of nontuberculous pleural effusion. Both men and women aged between 20 and 60 years were tested. The mean age range of tuberculous pleural effusion was 35 ± 15.32 years and that of nontuberculous exudative pleural effusion was 42.2 ± 13.34 years. Of the 50 patients with tuberculous pleural effusion, 25 were male and 25 were female. Of the 50 controls with nontuberculous pleural effusion, 29 were male and 21 were female. In group I, the mean values ​​of serum amylase and pleural fluid amylase were 53.044 and 77.122, respectively. In group II or controls, the mean values ​​of serum amylase and pleural fluid amylase were 49.508 and 63.238, respectively. Conclusion: Serum and pleural amylase levels indicate coexisting pancreatic, gastrointestinal, and malignant pathologies. Our study shows that the diagnosis of tuberculous pleural effusion by measuring amylase levels is neither sensitive nor specific.