Pleural Fluid Interleukin-32 as a Diagnostic Biomarker for Tuberculous Pleural Effusions in Bangladesh: A Cross-Sectional Study
Keywords:
Interleukin 32 (IL-32); tuberculous pleural effusion (TPE), adenosine deaminase (ADA).Abstract
Background: Tuberculous pleural effusion (TPE) is one of the most common types of extrapulmonary tuberculosis, and a definite diagnosis based on biomarkers is very challenging. Interleukin 32 (IL-32) is an inflammatory cytokine, crucial for the host immune response to tuberculosis. The purpose of this study is to determine the performance of IL-32 in the diagnosis of TPE.
Materials and methods: This cross-sectional observational study was conducted in the Department of Respiratory Medicine of Bangladesh Medical University (BMU) among 50 participants aged 18-70 years who fit the inclusion and exclusion criteria. Pleural fluid was assessed for IL-32 and ADA via enzyme-linked immunosorbent assay to determine the diagnostic performance and compare them.
Results: A total of 23 TPE and 27 non-TPE were identified by means of pleural biopsy findings, and in both instances males were predominant. Mean (±SD) age of TPE participants was 34.6 ± 17.3 years, and that of non-TPE was 57.32 ± 11.42 years. The most common symptoms were weight loss, anorexia, and fever in the TBE group. Mean pleural protein, lymphocyte, and ADA concentrations were significantly different between TPE and non-TPE (p-values <0.05, <0.001, and <0.001, respectively) but not for glucose and LDH (p-values 0.05 and 0.05). Also mean (±SD) pleural IL-32 levels were also significantly elevated in TPE (435.4 +360.3ng/L) compared to non-TPE (130.2 +80.0ng/L), (p value <0.001). An IL-32 cutoff of >240.8 pg/ml effectively diagnosed TPE with a sensitivity of 87.3, specificity of 94.3 and area under the curve (AUC) of 0.923.
Conclusion: Interleukin-32 may play an important role in the diagnosis of TPE with its high diagnostic accuracy compared with adenosine deaminase.
J MEDICINE 2026; 27(2): 72-77
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