The Role of Systemic Inflammatory Indices in Children with Parapneumonic Pleural Effusion

Document Type : Original Article

Authors

1 Pediatric Department, Ain Shams University

2 Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

3 Pediatrics Department, Ain Shams University

4 Department of Clinical Pathology/ Immunology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

5 Pediatrics Department, Faculty of Medicine, Ain Shams University, Egypt

6 Pediatrics, Faculty of Medicine , Ain Shams University, Egypt

Abstract

Background: Parapneumonic effusion (PPE) is a common complication of community-acquired pneumonia (CAP) in children, classified as complicated (CPPE) or uncomplicated (UPPE). Differentiating between these types aids in appropriate management and improves outcomes. This study evaluates the diagnostic utility of systemic inflammatory indices in distinguishing CPPE from UPPE in pediatric patients. Methods: A cross-sectional study of 90 children with PPE categorized into CPPE and UPPE groups based on laboratory and imaging findings. Systemic immune inflammatory index (SII), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), derived neutrophil-to-lymphocyte ratio (dNLR), lymphocyte-monocyte ratio (LMR), and C-reactive protein/albumin (CRP/Alb) ratio were calculated. Results: The CRP/Alb ratio was significantly higher in the CPPE group (p = 0.013). ROC analysis identified a CRP/Alb ratio >113.46 as a predictor of CPPE with 85.71% specificity and 44.12% sensitivity. Multivariate regression analysis identified parainfluenza virus infection and the CRP/Alb ratio as significant predictors of CPPE (OR = 17.12, p = 0.009).
Conclusions: Among the inflammatory indices analyzed, the CRP/Alb ratio was the most reliable marker for differentiating CPPE from UPPE.

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The Egyptian Journal of Pediatric Allergy and Immunology
Volume 23, Issue 2
October 2025
Pages 82-88

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