Causes of Pleural Effusion - Differential Diagnosis Algorithm
Exudative Effusion:
- Pulmonary
• Infectious
• Neoplastic
• Inflammatory (RA, SLE)
• Pulmonary Embolus*
• Chylothorax
• Hemothorax
Gastrointestinal
• Ruptured Esophagus*
• Pancreatitis
Transudative Effusion:
- Increased Hydrostatic Pressure
• Congestive Heart Failure
• Renal Failure with Hypervolemia
• (Early) Pulmonary Embolus
- Decreased Oncotic Pressure
• Cirrhosis
• Nephrotic Syndrome
Light's Criteria:
- Pleural Fluid Protein/Serum Protein > 0.5
- Pleural Fluid Lactate Dehydrogenase (LDH)/Serum LDH > 0.6
- Pleural Fluid LDH > 2/3 Serum LDH Upper Limit of Normal
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