Wildani Muhammad Maulana, Singh Gurmeet
Department of Internal Medicine, Cipto Mangunkusumo Hospital - Faculty of Medicine Universitas Indonesia, Jakarta, IDN.
Division of Respirology and Critical Illness, Department of Internal Medicine, Cipto Mangunkusumo Hospital - Faculty of Medicine Universitas Indonesia, Jakarta, IDN.
Cureus. 2023 Jul 26;15(7):e42480. doi: 10.7759/cureus.42480. eCollection 2023 Jul.
Tuberculosis can alter the permeability of the pleura and result in tuberculous pleural effusion. Clinical manifestation is similar to malignant pleural effusion making it challenging to distinguish. Tumor marker cancer antigen 125 (CA-125) level of pleural fluid could be an alternative in diagnosing tuberculous pleural effusion. We reported a case of a 41-year-old female with shortness of breath and a history of chronic kidney disease, acute decompensated heart failure, and community-acquired pneumonia. The patient underwent tuberculosis examination and yielded negative result, yet the serum CA-125 examination yielded positive result. A literature search was performed on electronic databases with appropriate search terms based on the established clinical question and a total of three cross-sectional studies were selected based on the eligibility criteria. CA-125 level of pleural fluid sample was found to have a good diagnostic value compared to the blood serum sample. However, further research is necessary to determine a proper cut-off value for a significant result.
肺结核可改变胸膜通透性，导致结核性胸腔积液。其临床表现与恶性胸腔积液相似，难以鉴别。胸水肿瘤标志物癌抗原125（CA-125）水平可作为诊断结核性胸腔积液的一项指标。我们报告了一例41岁女性患者，有气短症状，既往有慢性肾脏病、急性失代偿性心力衰竭和社区获得性肺炎病史。该患者结核检查结果为阴性，但血清CA-125检查结果为阳性。根据既定临床问题，使用适当检索词在电子数据库中进行文献检索，根据纳入标准共筛选出三项横断面研究。结果发现，与血清样本相比，胸水样本的CA-125水平具有良好的诊断价值。然而，需要进一步研究以确定具有显著诊断意义的合适临界值。
