Laboratory Test Reference Guide

Triglyceride in Pleural fluid

A chylous effusion contains chyle from the thoracic duct. Chylomicrons contain dietary fat and are produced after meals. 

Range of Triglyceride levels:

Chylous (n = 38): 0.56 – 26 mmol/L

Non-Chylous (n = 104): 0.14 – 1.25 mmol/L

Pleural fluids with a  triglyceride level > 1.25 mmol/L are most likely chylous and if triglycerides  < 0.56 mmol/L, pleural fluids are are unlikely to be chylous. Lipoprotein electrophoresis can be performed to check for chylomicrons when triglyceride is in the range of 0.56 – 1.25 mmol/L, please contact the laboratory to arrange (needs to be pre-arranged with the referral laboratory)

False negatives (= triglycerides below 1.25 mmol/L) may be seen in fasting or malnourished patients.

Reference : Staats, B. A., R. D. Ellefson, et al. (1980). "The lipoprotein profile of chylous and nonchylous pleural effusions." Mayo Clin Proc55 (11): 700-704.

Triglyceride in Peritoneal fluid

It is stated by experts that a peritoneal fluid is likely to be chylous if the triglyceride value is > 2.3 mmol/L and unlikely if < 0.56 mmol/L but supporting data is lacking. Lipoprotein electrophoresis can be performed to check for chylomicrons when triglyceride is in the range of 0.56 – 2.3 mmol/L, please contact the laboratory to arrange (needs to be pre-arranged with the referral laboratory)

B.Lizaola. et al. Review article: the diagnostic approach and current management of chylous ascites. Aliment.Pharmacol. Ther. 2017;46 B16 – B24

Said A. Al-Busafi. Achylous Ascitis: Evaluation and Management. Hepatology. 2014:2014:240473

Pres OW. Evaluation and management of chylous ascites. Ann Intern Med. 1982:96: 358 - 364