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Drugs and the pleura
1Division of Pulmonary and Critical Care Medicine, Allergy and Clinical Immunology, Medical University of South Carolina, Charleston 29425, USA.
Chest
|July 29, 1999
Summary
This review identifies drugs causing pleural disease, detailing clinical and radiographic findings. Treatment involves drug withdrawal, with corticosteroids for persistent cases, improving patient outcomes.
Area of Science:
- Pulmonology
- Pharmacology
- Medical Toxicology
Background:
- Drug-induced pleural disease is a recognized clinical entity.
- A comprehensive review of associated drugs and their effects is warranted.
Purpose of the Study:
- To identify drugs linked to pleural disease.
- To review clinical, radiographic, and pleural fluid findings.
- To examine the natural history and therapeutic response of drug-induced pleural reactions.
Main Methods:
- Searched MEDLINE and bibliographies for English-language articles (1966-1998).
- Assessed case reports, letters, and reviews for drug-associated pleural effusion, pleuritis, or thickening.
- Analyzed causality based on drug exposure, withdrawal, and re-challenge.
Main Results:
- A limited number of drugs induce pleural disease compared to parenchymal lung disease.
- Key findings include clinical presentation, radiographic signs, and pleural fluid analysis.
- Treatment efficacy varied, with drug withdrawal being primary.
Conclusions:
- Drug-induced pleural disease is less common than parenchymal lung disease.
- Primary treatment involves discontinuing the offending drug.
- Corticosteroids may be used for refractory cases, reducing patient morbidity.