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首页> 外文期刊>Case Reports in Nephrology >The Use of Pleural Fluid to Serum Glucose Ratio in Establishing the Diagnosis of a Not So Sweet PD-Related Hydrothorax: Case Report and Literature Review
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The Use of Pleural Fluid to Serum Glucose Ratio in Establishing the Diagnosis of a Not So Sweet PD-Related Hydrothorax: Case Report and Literature Review

机译：使用胸腔液与血清血糖比，建立诊断的诊断不那么甜蜜的PD相关的卧罗西克斯：病例报告和文献综述

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摘要

Hydrothorax is a well-known but rare complication of peritoneal dialysis (PD), with an average incidence of 2% mainly in cases of continuous ambulatory peritoneal dialysis (CAPD). In more than 80% of these cases, the hydrothorax is attributed to an abnormal pleuroperitoneal communication. It commonly manifests as unilateral effusion, predominantly on the right. A thoracentesis to determine pleural glucose has been a diagnostic aid well relied on, as the dextrose rich dialysate raises the pleural fluid glucose. A pleural fluid glucose to serum glucose gradient greater than 50?mg/dL is suggestive of a leak with a specificity of 100% according to some studies; however, its sensitivity is variable. Our case illustrates a diagnostic dilemma due to a relatively low pleural fluid to serum glucose gradient of 21?mg/dL that caused a delay in diagnosis. A pleural fluid to serum glucose ratio 1.0 was used as a diagnostic marker that pointed toward a peritoneal leak. For confirmation, a peritoneal scintigraphy with nuclear technetium 99 scan was performed that revealed a pleuroperitoneal fistula as the source of the recurring hydrothorax in the setting of automated peritoneal dialysis (APD). The hydrothorax completely resolved with termination of APD on follow-up as the patient was transitioned to intermittent hemodialysis (HD).
机译：Hydroothorax是腹膜透析（Pd）的众所周知但罕见的并发症，平均发病率为2％，主要是在连续的车身腹膜透析（CAPD）的情况下。在80％以上的这些病例中，HydroproRax归因于异常的胸膜内沟通。它通常表现为单侧积液，主要是在右侧。确定胸腔葡萄糖的胸腔饱和度是依赖于诊断助剂，因为葡萄糖富透析液升高了胸膜流体葡萄糖。血清葡萄糖梯度的胸膜葡萄糖大于50Ω·mg / dL，根据一些研究提示一种泄漏的泄漏，其特异性为100％;但是，它的敏感性是可变的。我们的案例说明了由于血清葡萄糖梯度为21Ωmg/ d1的血清葡萄糖梯度导致的诊断困境。胸膜血清葡萄糖比> 1.0用作诊断标志物，指向腹膜泄漏。为了确认，进行核技术99扫描的腹膜闪烁图，揭示了一种胸膜内瘘，作为重复腹膜透析（APD）的重复湿润素来源。随着患者转变为间歇性血液透析（HD），液体嗜胞混合物完全分解的APD终止。

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