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Light's Criteria for Exudative Effusions

Distinguishes exudative from transudative pleural effusions using paired fluid and serum chemistries.

Light's Criteria for Exudative Effusions
Pleural fluid protein
g/dL
Serum protein
g/dL
Pleural fluid LDH
U/L
Serum LDH
U/L
Upper limit of normal for serum LDH (assay-specific)
U/L
Complete the fields above to see the result.

When to use

  • Classifying a new pleural effusion as exudative or transudative to direct the differential diagnosis and further work-up.

Formula

Exudate if any one of: pleural/serum protein >0.5; pleural/serum LDH >0.6; pleural LDH > 2/3 the assay's upper limit of normal for serum LDH.

Pearls and pitfalls

  • Sensitivity for exudates is very high (~98%), but roughly 25% of transudates are misclassified as exudates, especially in patients on diuretics — consider serum-to-pleural albumin gradient if the clinical picture is discordant.

References

  1. Light RW, Macgregor MI, Luchsinger PC, Ball WC Jr. Ann Intern Med. 1972;77(4):507-13.