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Mediators of Inflammation
Volume 2011, Article ID 237638, 5 pages
Research Article

Serum Amyloid Alpha in Parapneumonic Effusions

1Respiratory Department, University Hospital of Larissa, Biopolis, 41110 Larissa, Greece
2“Sismanoglio” General Hospital of Attica, 15126 Athens, Greece
3Intensive Care Unit, University Hospital of Thessaly, Biopolis, 41110 Larissa, Greece
4Respiratory Department, Chania General Hospital, 73300 Chania, Greece

Received 5 June 2011; Accepted 16 June 2011

Academic Editor: Dennis Daniel Taub

Copyright © 2011 Vagelis Boultadakis et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Study objectives. To assess serum amyloid alpha (SAA) pleural fluid levels in parapneumonic effusion (PPE) and to investigate SAA diagnostic performance in PPE diagnosis and outcome. Methods. We studied prospectively 57 consecutive patients with PPE (empyema (EMP), complicated (CPE), and uncomplicated parapneumonic effusion (UPE)). SAA, CRP, TNF-α, IL-1β, and IL-6 levels were evaluated in serum and pleural fluid at baseline. Patients were followed for 6-months to detect pleural thickening/loculations. Results. Pleural SAA levels (mg/dL) median(IQR) were significantly higher in CPE compared to UPE ( ); CRP levels were higher in EMP and CPE compared to UPE ( ). There was no significant difference between IL-1β, IL-6, TNF-α level in different PPE forms. No significant association between SAA levels and 6-month outcome was found. At 6-months, patients with no evidence of loculations/thickening had significantly higher pleural fluid pH, glucose levels ( ), lower LDH ( ), IL-1β levels ( ) compared to patients who presented pleural loculations/thickening. Conclusions. SAA is increased in complicated PPE, and it might be useful as a biomarker for UPE and CPE diagnosis. SAA levels did not demonstrate considerable diagnostic performance in identifying patients who develop pleural thickening/loculations after a PPE.