title: [Successful treatment of pleurodesis for seemingly intractable pleural effusion in pleural amyloidosis with rheumatoid arthritis].
abstract: We report a case of secondary amyloidosis with pleural involvement in a patient with rheumatoid arthritis. A 77-year-old man had received a diagnosis of rheumatoid arthritis 10 years previously. Bilateral pleural effusion of unknown etiology was noted 2 years prior to admission. A biopsy of the left pleura by video-assisted thoracic surgery did not reveal any evidence of the cause of his pleural effusion. The histological findings revealed chronic inflammation of the pleura on a hematoxylin-eosin (HE) stain, but treatment with an increased dose of corticosteroid did not improve his effusion. Right pneumothorax then developed. Based on the histological findings of a Congo red stain, the diagnosis was changed to pleural amyloidosis. An initial attempt at pleurodesis with OK-432 and a pleural patch with the patient's own blood was attempted but was not successful. Subsequently, pleurodesis with OK-432 and the patient's own blood improved his pleural effusion and pneumothorax. Pleural involvement in amyloidosis is extremely rare and is difficult to treat.
authors.affiliation: Department of Respiratory Medicine, Kumamoto University Hospital.
authors.forename: Aiko
authors.initials: A
authors.lastname: Masunaga
authors.forename: Nahoko
authors.initials: N
authors.lastname: Takeda
authors.forename: Kimitaka
authors.initials: K
authors.lastname: Akaike
authors.forename: Kaori
authors.initials: K
authors.lastname: Tsumori
authors.forename: Eisuke
authors.initials: E
authors.lastname: Goto
authors.forename: Hidenori
authors.initials: H
authors.lastname: Ichiyasu
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Kohrogi
mesh_terms: D000368:Aged; D000686:Amyloidosis / Q000150:complications*; D001172:Arthritis, Rheumatoid / Q000150:complications*; D001769:Blood; D006801:Humans; D008297:Male; D010844:Picibanil / Q000627:therapeutic use; D010995:Pleural Diseases / Q000150:complications*; D010996:Pleural Effusion / Q000209:etiology / Q000628:therapy*; D018700:Pleurodesis / Q000379:methods
chemical_list: D010844:Picibanil