Diagnostic Approach to a Case of Serositis

Atul Singh Rajput, Ulhas Ja

Abstract

Effusions can be labeled as inflammatory (exudative) or non-inflammatory (transudative) depending upon the pathophysiological process involved. Various biomarkers (fluid glucose, fluid proteins, fluid albumin, protein ratio, protein gradient, albumin gradient) have been proposed for the same. In this study, we analysed all these biomarkers against the gold standard (cytology) and the practical utility of fluid adenosine deaminase (ADA) for diagnosing Tubercular serositis in a Tuberculosis prevalent area like that of ours. We found that albumin gradient proves its versatility in differentiating the pathophysiological nature of the effusion. We henceforth propose a minimum must step ladder diagnostic algorithm for a case of serositis, thereby cutting the costs of evaluation.