Glucose and Amylase in Pleural Effusions

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Abstract
Pleural fluid glucose and amylase levels were measured in a prospective study of 176 effusions. Contrary to some previous opinions, we found that in the great majority of tuberculous pleural fluids the glucose concentration was high (mean, 81.7 mg/100 ml) rather than low. Glucose levels in most but not all neoplastic fluids was also high (less than 60 mg/100 ml in only six of 43). Some effusions associated with pneumonia had glucose levels of more than 60 mg/100 ml even though bacterial cultures were positive. The level of pleural fluid amylase was high ( > 160 units/100 ml) in patients with pancreatitis and with pancreatic tumor; and a high amylase level was the first indication of pancreatic disease in two cases. Etiologic diagnosis on the basis of chemical analysis of pleural fluid without other supporting evidence is unreliable.

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