Diagnostic procedure for idiopathic eosinophilic pleural effusion: a single-center experience
Open Access
- 3 April 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Pulmonary Medicine
- Vol. 20 (1), 1-7
- https://doi.org/10.1186/s12890-020-1108-z
Abstract
Eosinophilic pleural effusion (EPE) is attributed to several well-recognised causes. However, some patients remain idiopathic, even after thorough clinical work-up. The present study aimed to better characterize idiopathic EPE (IEPE) and to outline the diagnostic procedure for this disease. Complete clinical data of 11 consecutive patients with IEPE were prospectively collected and analysed. Preliminary diagnostic procedure of IEPE in our hospital was performed. All the 11 patients had respiratory symptoms and unilateral pleural effusion (PE) occurred in 4 patients. The mean percentage of eosinophils in PE was 22.4% (range, 12.4–50.5%). Lactate dehydrogenase, adenosine deaminase, proteins and carcinoembryonic antigen in PE were 246.0 U/L (range, 89.8–421.9 U/L), 13.8 U/L (range, 1.8–24.0 U/L), 42.6 g/dl (range, 32.8–52.6 g/dl) and 2.17 mg/mL (range, 0.46–4.31 mg/mL), respectively. Parasite-specific IgG antibody in blood and parasite eggs in stool were both negative. No evidence of tuberculosis or malignancy was observed in pleural biopsy. Symptoms and abnormal pulmonary imaging were eliminated after glucocorticoid use. IEPE is a diagnosis of exclusion. Patients with EPE without a clear cause should be asked to provided complete medical, surgical and drug-related histories. A thorough work-up is essential. Moreover, we recommend follow-up after the use of glucocorticoid until effusion resolves. GYFYY. Registration No: GYFYY20150901221. Registered time: 1 September 2015. Date of enrolment of the first participant to the trial: 22 January 2016.Keywords
Funding Information
- The study was supported by grants from the Foundation of Guangzhou Institute of Respiratory Health (GIRH201503)
This publication has 29 references indexed in Scilit:
- Derrames pleurales eosinofílicos: incidencia, etiología y significado pronósticoArchivos de Bronconeumología, 2011
- The Prevalence and Diagnostic Significance of Eosinophilic Pleural Effusions: A Meta-Analysis and Systematic ReviewRespiration, 2011
- Investigation of a unilateral pleural effusion in adults: British Thoracic Society pleural disease guideline 2010Thorax, 2010
- A systematic approach to the investigation and diagnosis of a unilateral pleural effusionInternational Journal of Clinical Practice, 2009
- Incidence and aetiology of eosinophilic pleural effusionEuropean Respiratory Journal, 2009
- BTS guidelines for the investigation of a unilateral pleural effusion in adultsThorax, 2003
- Diagnostic utility of eosinophils in the pleural fluidEuropean Respiratory Journal, 2000
- Etiology and Prognostic Significance of Eosinophilic Pleural EffusionsSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1996
- Eosinophilic Pleural Effusion: A Review of 36 CasesRespiration, 1985
- Diagnostic utility of pleural fluid eosinophiliaThe American Journal of Medicine, 1984