PURPOSE: Many different conditions result in pleural effusions (PEs) and making the differential diagnosis of PE is difficult. The purpose of the present study was to document the change of incidence and compare the etiologies of PEs with regards to age, the sidedness and characteristics of PE. METHODS: During the 10-year period from 1986 to 1995, thoracentesis was performed in 197 children with PEs at Seoul National University Children's Hospital. The hospital records of these children were reviewed, and radiologic findings and laboratory data of PE were analyzed. RESULTS: The distribution of the etiologies of PEs changed with the declining incidence of tuberculous PE. Infectious PE was the leading cause of PE in each age group. The most common etiology of infectious PE in children aged less than 3 years was bacterial PE, aged 3 to 6 years mycoplasma PE, and aged more than 6 years tuberculous PE. Malignant PE was the second most frequent cause of PE and the incidence of it was marked in children aged 3 to 6 years. Non-Hodgkin lymphoma was the most frequent cause of malignant PE and Burkitt lymphoma and leukemia were the next two leading causes of it. The sidedness of the PE was not helpful in differentiating various types of PEs. Measurements of the pleural fluid protein & glucose were not useful either. Bacterial PE presented the highest LDH activity. Infectious PE presented higher pleural fluid leukocyte count than any other type of PE, and bacterial PE was most prominent in this respect. The PE polymorphonuclear leukocyte % was marked in bacterial PE and the PE lymphocyte % in tuberculous PE. CONCLUSION: The distribution of the etiologies of PEs seems to have changed. Age, LDH, leukocyte count and differential cell count of PE were helpful in differentiating various types of PEs.
Burkitt Lymphoma ; Cell Count ; Child* ; Diagnosis, Differential ; Glucose ; Hospital Records ; Humans ; Incidence ; Leukemia ; Leukocyte Count ; Lymphocytes ; Lymphoma, Non-Hodgkin ; Mycoplasma ; Neutrophils ; Pleural Effusion* ; Seoul

JL1, a specific epitope on CD43, is a potential biomarker for the diagnosis of acute leukemia. Although qualitative assays for detecting leukemia-specific CD43 exist, there is a need to develop quantitative assays for the same. Here, we developed two novel monoclonal antibodies (mAbs), 2C8 and 8E10, recognizing different epitopes on CD43. These clones are capable of pairing with YG5, another mAb against JL1 epitope, because they were selectively obtained using sandwich ELISA. Antigens recognized by 2C8 and 8E10 were confirmed as CD43 by western blotting using the CD43-hFC recombinant protein. When expression on various leukemic cell lines was investigated, 2C8 and 8E10 displayed a disparity in the distribution of the epitope. Enzyme assays revealed that these mAbs recognized a sialic acid-dependent epitope on CD43. Using normal thymus and lymph node paraffin-embedded tissues, we confirmed a difference in the epitopes recognized by the two mAbs that was predicted based on the maturity of the cells in the tissue. In summary, we developed and characterized two mAbs, 2C8 and 8E10, which can be used with YG5 in a sandwich ELISA for detecting leukemia-specific CD43.
Antibodies, Monoclonal ; Blotting, Western ; Cell Line ; Clone Cells ; Diagnosis ; Enzyme Assays ; Enzyme-Linked Immunosorbent Assay ; Epitopes* ; Leukemia ; Lymph Nodes ; Thymus Gland