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Categorization of pleural effusions as transudates or exudates assists diagnostic and therapeutics decisions. To meet the criteria of Light et al. (1) for exudates, an effusion must have at least one of the following: a ratio of pleural fluid (PF) protein to serum protein >0.5, a ratio of PF to serum lactic dehydrogenase (LD) >0.6, and PF LD more than two-thirds the upper limit of normal for serum LD. Numerous studies have examined the diagnostic accuracy of these criteria, which misdiagnose 10–30% of transudates as exudates (2)(3).Recently in this Journal, Chen and Lam (4) reported that qualitative protein zone electrophoresis is more sensitive (100% vs 95%) and specific (50% vs 38%) than the criteria of Light et al. (1) in a study of 51 patient samples (8 transudates and 43 exudates). Moreover, when quantitative analysis was performed, the PF α2-globulin:albumin ratio at the best cutoff point (0.28) showed a sensitivity and specificity of 85% and 80%, respectively.To determine whether protein capillary electrophoresis rather than protein zone electrophoresis meets the accuracy of the criteria of Light et al. (1), we prospectively studied 116 adult patients with pleural effusions over a 1-year period. On the basis of predetermined clinical criteria (2)(3)(4), there were 29 … [↵][1]bAuthor for correspondence. Fax 852-2636-5090; e-mail ching-wanlam{at}cuhk.edu.hk. [1]: #xref-corresp-2-1

Pleural Protein Capillary Electrophoresis for the Separation of Transudates and Exudates