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Revista Medica Herediana

versión impresa ISSN 1018-130Xversión On-line ISSN 1729-214X

Resumen

CASTANEDA SALDANA, Enrique  y  APARICIO MEJIA, Jesús Manuel. Valor del líquido pericárdico con relación a la biopsia pericárdica en el diagnóstico de pericarditis efusiva tuberculosa. Rev Med Hered [online]. 2000, vol.11, n.4, pp.122-129. ISSN 1018-130X.

Objectives:To determine the value of the pericardial fluid in relationship to pericardial biopsy in tuberculous pericardial effusion and degree of agreement among the diagnosis for pericardial fluid and the diagnosis for pericardial biopsy. Material and methods: The medical records of 19 patients with pre-operative diagnosis of pericardial effusion, attended at the service of Thorax and cardiovascular surgery of the Hospital Nacional Cayetano Heredia, among the years 1994 and 1999, were examined. It was considered confirmed diagnosis of tuberculous pericarditis patients that completed the following approaches for study of pericardial fluid (positive culture for Bacillus of Koch or positive direct exam of Bacillus of Koch or level of ADA more than 50 UI/L) or the following approaches for study of pericardial biopsy (Positive culture for Bacillus of Koch or granulomas with caseous necrosis and/or Langhan’s giant cells, or presence of BAAR in the sample). Results: Of 19 patients with pericardial effusion, 12 patients had the confirmed diagnosis of tuberculous pericarditis, according to established approaches. Of these 12 patients, 6 patients fulfilled both approaches, 5 patients with the approaches for study of pericardial fluid, and one patient, with the approaches for study of pericardial biopsy. It was obtained a sensibility and specificity of 85.7% and 58.3% respectively, for the study of pericardial fluid , with positive predictive value and negative predictive value of 54.5% and 87.5% respectively. Also the degree of agreement between both diagnosis methods was 0.394. Conclusion:The study of pericardial fluid in the tuberculous pericardial effusion, has bigger utility to discard this etiology that to confirm it, for what is necessary to carry out the pericardial biopsy to confirm the tuberculous etiology. ( Rev Med Hered 2000; 11:122-129 ).

Palabras clave : Pericarditis; tuberculous pericarditis; pericardial biopsy; pericardial fluid.

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