Santotoribio Jose D, Nuñez-Jurado David, Rubio-Prieto Jose L, Guerrero Juan M, Corral-Pérez Juan, Fernández-Alba Juan J
Department of Laboratory Medicine, Puerto Real University Hospital, 11510 Cadiz, Spain.
Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), 11009 Cadiz, Spain.
Diagnostics (Basel). 2025 Apr 24;15(9):1086. doi: 10.3390/diagnostics15091086.
Parapneumonic pleural effusion (PPE) secondary to community-acquired pneumonia is the most common cause of pediatric pleural effusion. This study aimed to evaluate the pleural fluid characteristics of pediatric patients with PPE and to compare biomarkers between infants (1-12 months) and children (1-14 years). Fifty-four pediatric patients (14 infants and 40 children) with PPE were included. Pleural fluid samples were analyzed for white blood cell (WBC) count, glucose, total protein, lactate dehydrogenase (LDH), adenosine deaminase (ADA), and pH levels. Differences between age groups and correlations between age and pleural fluid biomarkers were assessed. Most pediatric PPE cases exhibited biochemical characteristics consistent with pleural exudate: WBC > 1000 cells/µL, total protein > 3 g/dL, LDH > 200 U/L. Infants showed a predominance of mononuclear WBC, while children exhibited a predominance of polymorphonuclear WBC. Glucose levels were higher, and total protein levels were lower in infants compared to children. Age was positively correlated with polymorphonuclear WBC percentage (rho = 0.509, < 0.001) and protein levels (rho = 0.622, < 0.001), whereas glucose levels were negatively correlated with age (rho = -0.274, = 0.043). Age-specific differences in pleural fluid biomarkers were observed in pediatric patients with PPE, suggesting a more robust and acute inflammatory response in children compared to infants. These findings underscore the importance of considering age-related variations in the inflammatory response when diagnosing and managing PPE in pediatric populations.
社区获得性肺炎继发的类肺炎性胸腔积液（PPE）是儿童胸腔积液最常见的原因。本研究旨在评估PPE患儿的胸腔积液特征，并比较婴儿（1至12个月）和儿童（1至14岁）之间的生物标志物。纳入了54例患有PPE的儿科患者（14例婴儿和40例儿童）。对胸腔积液样本进行白细胞（WBC）计数、葡萄糖、总蛋白、乳酸脱氢酶（LDH）、腺苷脱氨酶（ADA）和pH水平分析。评估年龄组之间的差异以及年龄与胸腔积液生物标志物之间的相关性。大多数儿科PPE病例表现出与胸腔渗出液一致的生化特征：WBC>1000个细胞/µL，总蛋白>3g/dL，LDH>200U/L。婴儿以单核WBC为主，而儿童以多形核WBC为主。与儿童相比，婴儿的葡萄糖水平较高，总蛋白水平较低。年龄与多形核WBC百分比（rho = 0.509，<0.001）和蛋白水平（rho = 0.622，<0.001）呈正相关，而葡萄糖水平与年龄呈负相关（rho = -0.274，= 0.043）。在患有PPE的儿科患者中观察到胸腔积液生物标志物的年龄特异性差异，表明与婴儿相比，儿童的炎症反应更强且更急性。这些发现强调了在诊断和管理儿科人群的PPE时考虑炎症反应中与年龄相关变化的重要性。
