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Clinical Investigations: The PleuraEvolution of Idiopathic Pleural Effusion: A Prospective, Long-term Follow-up Study
Section snippets
Patients
Between January 1984 and March 1991, 394 patients with pleural effusion were admitted to our department. Initial studies included the following: medical history to rule out exposure to asbestos or previous drug ingestion; complete physical examination; blood analysis; chest radiograph; and tuberculin test. Studies on pleural fluid obtained by thoracentesis included the following: determination of the levels of glucose, protein, adenosine deaminase, and lactate dehydrogenase; bacteriologic study
RESULTS
Baseline clinical and radiologic data for the 40 patients (30 men and 10 women) at diagnosis are shown in Table 2. A summary of the pleural fluid findings and the procedures used in the diagnostic workup are shown in Table 3. In the 19 patients with positive tuberculin tests, the pleural fluid was lymphocytic in 16 and polymorphonuclear in 3. In the 21 patients with negative tuberculin tests, the pleural fluid was lymphocytic in 19 and polymorphonuclear in 2. All patients had adenosine
DISCUSSION
The results of this study show that an idiopathic pleural effusion with no clinical or radiologic evidence of malignancy resolves spontaneously, albeit on occasions (12%) after a prolonged period of time or several relapses. A major finding in this study was that none of the patients developed tuberculosis during the follow-up period, despite the fact that 19 patients had a positive tuberculin test. The current recommendation for antituberculous treatment for patients with idiopathic pleural
ACKNOWLEDGMENT
The writers thank Cristina O'Hara for help with translation.
REFERENCES (36)
- et al.
The diagnosis of pleural effusions by fiberoptic bronchoscopy and pleuroscopy
Chest
(1981) - et al.
Points to consider when choosing a biopsy method in cases of pleurisy of unknown origin
Chest
(1983) Perplexing pleural effusion
Chest
(1978)- et al.
Clinical characteristics of the patients with nonspecific pleuritis
Chest
(1988) - et al.
Fiberoptic bronchoscopy and pleural effusion of unknowm origin
Chest
(1986) - et al.
Adenosine deaminase in pleural fluids: test for diagnosis of tuberculous pleural effusion
Chest
(1983) - et al.
Diagnosis of tuberculous pleurisy using the biologic parameters adenosine deaminase, lysozyme, and interferon gamma
Chest
(1993) - et al.
Thoracoscopy: a review of 121 consecutive surgical procedures
Ann Thorac Surg
(1989) - et al.
Carcinomatous involvement of the pleura: an analysis of 96 patients
Am J Med
(1977) Pleural effusion in lung cancer
Clin Chest Med
(1993)
Pericardial constriction
Am Heart J
Pleural effusion: a diagnostic dilemma
JAMA
Pleural effusion: laboratory test in 300 cases
Thorax
Pleural effusions
Mayo Clin Proc
The pleura
Am Rev Respir Dis
Pleural diseases
Initial tuberculous pleuritis in the Finnish Armed Forces in 1939–1945 with special reference to eventual post pleuritic tuberculosis
Acta Tuberc Scand
Primary serofibrinous pleural effusion in military personnel
Am Rev Tuberc
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revision accepted December 20