Drug-induced lupus pleuritis mimicking pleural space infection.
A 78-year-old man presented with acute lupus pleuritis due to procainamide. The pleural fluid was a turbid, yellow exudate with a WBC count of 53,200/cu mm (70 percent polymorphonuclear leucocytes), LDH of 4,296 IU/L, and pH of 7.195. Although these fluid characteristics suggested pleural space infection, they were due to pleural inflammation from drug-induced lupus. LE cells were present in the fluid and results of microbiologic studies were negative. Clinical and roentgenographic improvement followed discontinuation of procainamide.
Smith
P R
PR
Department of Medicine, State University of New York, Health Science Center, Brooklyn 11203.
Nacht
R I
RI
D000208:Acute Disease; D000368:Aged; D003937:Diagnosis, Differential; D006801:Humans; D007239:Infections / Q000175:diagnosis*; D008180:Lupus Erythematosus, Systemic / Q000139:chemically induced* / Q000175:diagnosis; D008297:Male; D010996:Pleural Effusion / Q000175:diagnosis; D010998:Pleurisy / Q000139:chemically induced* / Q000175:diagnosis; D011342:Procainamide / Q000009:adverse effects*
D011342:Procainamide