Efficacy of Matrix Metalloproteinase-9 in Differentiating Tuberculous from Non-Tuberculous Pleural Effusion

Introduction and Objective: Matrix metalloproteinase plays a role in fibrosis in tuberculous pleurisy. Inflammatory compounds with mononuclear cells are characteristic of TB pleural effusion (2). TB is also a major cause of pleural effusion (PE) and 31% of patients with TB develop PE. Materials and Methods: In this case-control study, carried out in Ali-ibn Abi Talib (AS) and Bu-Ali hospitals in Zahedan from 2013 to 2015, patients with exudative pleural effusion were selected through the convenience sampling method. After determining the cause of pleural effusion, the patients were divided into tuberculous pleural effusion (TPE) and non-tuberculous pleural effusion (non-TPE) groups, and their matrix metalloproteinase-9 levels were compared with ELISA. Findings: Eighty-four patients with exudative pleural effusion were examined in this study. Among them, 22 and 62 patients were put in the TB and non-TB groups, respectively. The means of matrix metalloproteinase-9 were significantly different between the two groups (p=0.01). The sensitivity, specificity, positive predictive value, and negative predictive value for determining the role of MMP-9 in tuberculous pleurisy were 86%, 69%, 50%, and 93%, respectively, with a cutoff point of 196 pg/mL Discussion and Conclusion: The matrix metalloproteinase-9 is a diagnostic test with good sensitivity and specificity. The mean level of matrix metalloproteinase-9 was lower in this study than other articles, which can affect the predictive value of this test. Keywords: pleural effusion, tuberculosis, matrix metalloproteinase-9