{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T04:15:17Z","timestamp":1792815317679,"version":"4.5.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:00:00Z","timestamp":1792713600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"},{"start":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:00:00Z","timestamp":1792713600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"funder":[{"name":"Universitas Indonesia (HIBAH PUTI Q1 2023).","id":[{"id":"https:\/\/ror.org\/0116zj450","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pulm Ther"],"DOI":"10.1007\/s41030-026-00388-5","type":"journal-article","created":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T13:36:48Z","timestamp":1792762608000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sequential Pleural Fluid and Serum Biomarker Measurements in Patients Undergoing Medical Thoracoscopy for Persistently Undiagnosed Pleural Effusion: A Pilot Study from a TB-Endemic Tertiary Centre"],"prefix":"10.1007","clinical-trial-number":[{"clinical-trial-number":"nct06159179","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0734-0660","authenticated-orcid":false,"given":"Gurmeet","family":"Singh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ray Bryan Charles","family":"Rattu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisnawati","family":"Rachmadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cleopas Martin","family":"Rumende","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yayi Dwina","family":"Billianti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dewi","family":"Wulandari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najib","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanny Kusuma","family":"Sary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belinda","family":"Magdalena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dicky Levenus","family":"Tahapary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffi Cong Andi","family":"Nata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aziza","family":"Harris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Rizki","family":"Triono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melvin Chee Kiang","family":"Tay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,23]]},"reference":[{"issue":"Suppl 2","key":"388_CR1","doi-asserted-by":"publisher","first-page":"ii4","DOI":"10.1136\/thx.2010.136978","volume":"65","author":"C Hooper","year":"2010","unstructured":"Hooper C, Lee YCG, Maskell N, BTS Pleural Guideline Group. Investigation of a unilateral pleural effusion in adults: British Thoracic Society Pleural Disease Guideline 2010. Thorax. 2010;65(Suppl 2):ii4-17. https:\/\/doi.org\/10.1136\/thx.2010.136978.","journal-title":"Thorax"},{"issue":"6","key":"388_CR2","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1586\/17476348.2015.1098535","volume":"9","author":"JM Porcel","year":"2015","unstructured":"Porcel JM, Azzopardi M, Koegelenberg CF, Maldonado F, Rahman NM, Lee YCG. The diagnosis of pleural effusions. Expert Rev Respir Med. 2015;9(6):801\u201315. https:\/\/doi.org\/10.1586\/17476348.2015.1098535.","journal-title":"Expert Rev Respir Med"},{"issue":"Suppl 3","key":"388_CR3","doi-asserted-by":"publisher","first-page":"s1","DOI":"10.1136\/thorax-2022-219784","volume":"78","author":"ME Roberts","year":"2023","unstructured":"Roberts ME, Rahman NM, Maskell NA, et al. British Thoracic Society guideline for pleural disease. Thorax. 2023;78(Suppl 3):s1\u201342. https:\/\/doi.org\/10.1136\/thorax-2022-219784.","journal-title":"Thorax"},{"key":"388_CR4","doi-asserted-by":"publisher","DOI":"10.1177\/1753466618808660","volume":"12","author":"JM Porcel","year":"2018","unstructured":"Porcel JM. Biomarkers in the diagnosis of pleural diseases: a 2018 update. Ther Adv Respir Dis. 2018;12:1753466618808660. https:\/\/doi.org\/10.1177\/1753466618808660.","journal-title":"Ther Adv Respir Dis"},{"issue":"3","key":"388_CR5","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1080\/10408363.2025.2559697","volume":"63","author":"JD Santotoribio","year":"2026","unstructured":"Santotoribio JD. Pleural fluid biomarkers for the diagnosis and management of malignant pleural effusions: a clinical review. Crit Rev Clin Lab Sci. 2026;63(3):237\u201360. https:\/\/doi.org\/10.1080\/10408363.2025.2559697.","journal-title":"Crit Rev Clin Lab Sci"},{"issue":"Suppl 2","key":"388_CR6","doi-asserted-by":"publisher","first-page":"ii54","DOI":"10.1136\/thx.2010.137018","volume":"65","author":"NM Rahman","year":"2010","unstructured":"Rahman NM, Ali NJ, Brown G, et al. Local anaesthetic thoracoscopy: British Thoracic Society Pleural Disease Guideline 2010. Thorax. 2010;65(Suppl 2):ii54-60. https:\/\/doi.org\/10.1136\/thx.2010.137018.","journal-title":"Thorax"},{"issue":"5","key":"388_CR7","doi-asserted-by":"publisher","first-page":"3142","DOI":"10.21037\/jtd-24-219","volume":"16","author":"KJ Goh","year":"2024","unstructured":"Goh KJ, Leong CKL, Young SL, et al. Diagnostic value and safety of medical thoracoscopy in undiagnosed pleural effusions: a prospective observational cohort study. J Thorac Dis. 2024;16(5):3142\u201351. https:\/\/doi.org\/10.21037\/jtd-24-219.","journal-title":"J Thorac Dis"},{"issue":"5","key":"388_CR8","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1007\/s00408-009-9165-3","volume":"187","author":"JM Porcel","year":"2009","unstructured":"Porcel JM. Tuberculous pleural effusion. Lung. 2009;187(5):263\u201370. https:\/\/doi.org\/10.1007\/s00408-009-9165-3.","journal-title":"Lung"},{"issue":"8","key":"388_CR9","first-page":"777","volume":"7","author":"S Greco","year":"2003","unstructured":"Greco S, Girardi E, Masciangelo R, Capoccetta GB, Saltini C. Adenosine deaminase and interferon gamma measurements for the diagnosis of tuberculous pleurisy: a meta-analysis. Int J Tuberc Lung Dis. 2003;7(8):777\u201386.","journal-title":"Int J Tuberc Lung Dis"},{"issue":"4","key":"388_CR10","doi-asserted-by":"publisher","first-page":"507","DOI":"10.7326\/0003-4819-77-4-507","volume":"77","author":"RW Light","year":"1972","unstructured":"Light RW, Macgregor MI, Luchsinger PC, Ball WC Jr. Pleural effusions: the diagnostic separation of transudates and exudates. Ann Intern Med. 1972;77(4):507\u201313. https:\/\/doi.org\/10.7326\/0003-4819-77-4-507.","journal-title":"Ann Intern Med"},{"issue":"3","key":"388_CR11","doi-asserted-by":"publisher","first-page":"164","DOI":"10.36497\/respirsci.v4i3.142","volume":"4","author":"H Harsini","year":"2024","unstructured":"Harsini H, Kurniawan YD, Sutanto YS. Carcinoembryonic antigen (CEA) and cancer antigen 125 (CA-125) as diagnostic biomarkers for malignant pleural effusion. Respir Sci. 2024;4(3):164\u201371. https:\/\/doi.org\/10.36497\/respirsci.v4i3.142.","journal-title":"Respir Sci"},{"key":"388_CR12","doi-asserted-by":"publisher","DOI":"10.1016\/j.coi.2025.102655","volume":"97","author":"G Clavarino","year":"2025","unstructured":"Clavarino G, Vigne J, Meuleman MS, Amen A, Rossi V, Dumestre-Perard C. Complement in systemic lupus erythematosus across time and space: from tolerance to tissue injury and from extracellular to intracellular functions. Curr Opin Immunol. 2025;97:102655. https:\/\/doi.org\/10.1016\/j.coi.2025.102655.","journal-title":"Curr Opin Immunol"},{"issue":"7","key":"388_CR13","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.42480","volume":"15","author":"MM Wildani","year":"2023","unstructured":"Wildani MM, Singh G. Diagnostic value of serum and pleural effusion cancer antigen 125 in tuberculosis diagnosis of non-cancer patients: an evidence-based case report. Cureus. 2023;15(7):e42480. https:\/\/doi.org\/10.7759\/cureus.42480.","journal-title":"Cureus"},{"issue":"3","key":"388_CR14","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0213728","volume":"14","author":"AN Aggarwal","year":"2019","unstructured":"Aggarwal AN, Agarwal R, Sehgal IS, Dhooria S. Adenosine deaminase for diagnosis of tuberculous pleural effusion: a systematic review and meta-analysis. PLoS ONE. 2019;14(3):e0213728. https:\/\/doi.org\/10.1371\/journal.pone.0213728.","journal-title":"PLoS ONE"},{"issue":"1","key":"388_CR15","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-17864-8","volume":"15","author":"X Lin","year":"2025","unstructured":"Lin X, Liu Y, Chen M, Bao A, Yang T. Development and validation of a predictive model for tuberculous pleural effusion with high adenosine deaminase. Sci Rep. 2025;15(1):31978. https:\/\/doi.org\/10.1038\/s41598-025-17864-8.","journal-title":"Sci Rep"},{"issue":"5","key":"388_CR16","doi-asserted-by":"publisher","first-page":"693","DOI":"10.5588\/ijtld.12.0635","volume":"17","author":"WI Choi","year":"2013","unstructured":"Choi WI, Qama D, Lee MY, Kwon KY. Pleural cancer antigen-125 levels in benign and malignant pleural effusions. Int J Tuberc Lung Dis. 2013;17(5):693\u20137. https:\/\/doi.org\/10.5588\/ijtld.12.0635.","journal-title":"Int J Tuberc Lung Dis"},{"issue":"2","key":"388_CR17","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.medcli.2020.10.017","volume":"158","author":"H Lin","year":"2022","unstructured":"Lin H, Ni L. Diagnostic utility of LDH, CA125 and CYFRA21-1 in tuberculosis pleural effusion. Med Clin (Barc). 2022;158(2):70\u20132. https:\/\/doi.org\/10.1016\/j.medcli.2020.10.017.","journal-title":"Med Clin (Barc)"},{"issue":"26","key":"388_CR18","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000003996","volume":"95","author":"A Verma","year":"2016","unstructured":"Verma A, Phua CK, Sim WY, et al. Pleural LDH as a prognostic marker in adenocarcinoma lung with malignant pleural effusion. Medicine (Baltimore). 2016;95(26):e3996. https:\/\/doi.org\/10.1097\/MD.0000000000003996.","journal-title":"Medicine (Baltimore)"},{"issue":"1","key":"388_CR19","doi-asserted-by":"publisher","DOI":"10.1186\/s12935-022-02518-w","volume":"22","author":"P Peng","year":"2022","unstructured":"Peng P, Yang Y, Du J, Zhai K, Shi HZ. Prognostic biomarkers of malignant patients with pleural effusion: a systematic review and meta-analysis. Cancer Cell Int. 2022;22(1):99. https:\/\/doi.org\/10.1186\/s12935-022-02518-w.","journal-title":"Cancer Cell Int"}],"container-title":["Pulmonary Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s41030-026-00388-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s41030-026-00388-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s41030-026-00388-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:04:45Z","timestamp":1792807485000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s41030-026-00388-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,23]]},"references-count":19,"alternative-id":["388"],"URL":"https:\/\/doi.org\/10.1007\/s41030-026-00388-5","relation":{},"ISSN":["2364-1754","2364-1746"],"issn-type":[{"value":"2364-1754","type":"print"},{"value":"2364-1746","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,23]]},"assertion":[{"value":"12 August 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Gurmeet Singh, Ray Bryan Charles Rattu, Lisnawati Rachmadi, Cleopas Martin Rumende, Yayi Dwina Billianti, Dewi Wulandari, Najib Ali, Sanny Kusuma Sary, Belinda Magdalena, Dicky Levenus Tahapary, Steffi Cong Andi Nata, Aziza Harris, Muhammad Rizki Triono and Melvin Chee Kiang Tay declare that they have no competing interests.","order":1,"name":"Ethics","label":"Conflict of Interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of the Faculty of Medicine, Universitas Indonesia (KET-1219\/UN2.F1\/ETIK\/PPM.00.02\/20225; 14 November 2022). All participants provided written informed consent for study participation, biomarker analysis, and publication of de-identified data. Separate procedural informed consent for medical thoracoscopy was obtained according to hospital practice. The parent study was prospectively designed and registered on ClinicalTrials.gov before enrolment under the original identifier NCT05553665; the registry now lists NCT06159179 as the current identifier and NCT05553665 as an obsolete identifier.","order":2,"name":"Ethics","label":"Ethical Approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}