Rheumatoid pleural effusion in the absence of arthritic disease.
Rheumatoid pleural effusion is an unusual complication of rheumatoid disease that typically presents subsequent to other more common manifestations of rheumatoid illness. The case of a 72-year-old woman with a rheumatoid pleural effusion is discussed. The patient presented with dyspnea, but without any history of rheumatoid arthritis. The patient was treated by thoracentesis, followed by video-thoracoscopy and pulmonary decortication. Postoperatively, the patient's effusion partially reaccumulated. Steroid therapy resulted in prompt and permanent resolution of the effusion. The patient remains asymptomatic 1 year after her presentation. The biochemical, serologic, and cytologic characteristics of rheumatoid effusions are reviewed.
Allan
James S
JS
Division of Thoracic Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. jallan@partners.org
Donahue
Dean M
DM
Garrity
Julie M
JM
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D010996:Pleural Effusion / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D011241:Prednisone / Q000627:therapeutic use; D011859:Radiography; D012217:Rheumatoid Factor / Q000097:blood; D020775:Thoracic Surgery, Video-Assisted; D016896:Treatment Outcome
D005938:Glucocorticoids; D012217:Rheumatoid Factor; D011241:Prednisone