Non infectious causes of acidotic pleural fluid acidosis

Q: Beside infection give at least five causes of acidotic pleural fluid acidosis with or without low glucose?

Answer: Complicated parapneumonic pleural effusion or empyema is the leading and 'proven otherwise cause of pleural fluid acidosis (pH less than 7.2) and/or low glucose. But there are few other causes which may have the similar laboratory findings and may mislead the clinician. 

• Malignancy
• Rheumatoid pleuritis
• Lupus pleuritis
• Urinothorax
• Misplaced central venous catheter infusing isotonic fluid 

On side note one infectious cause, which may goes missed particularly in developed countries where epidemiology is on lower side is tuberculosis.

#procedures

#pulmonary

#ID

#rheumatology

#oncology

#urology

# laboratory-medicine

References:

1. Sahn SA. State of the art. The pleura. Am Rev Respir Dis 1988; 138:184.

2. Zheng WQ, Hu ZD. Pleural fluid biochemical analysis: the past, present and future. Clin Chem Lab Med. 2022 Nov 17;61(5):921-934. doi: 10.1515/cclm-2022-0844. PMID: 36383033.