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Bilateral massive pleural effusions caused by uremic pleuritis.

C Yoshii1, S Morita, M Tokunaga

  • 1Department of Respiratory Disease, University of Occupational and Environmental Health, Kitakyushu.

Internal Medicine (Tokyo, Japan)
|August 17, 2001
PubMed
Summary

This case highlights a fatal instance of uremic pleuritis, a serious complication of hemodialysis. Despite treatment, the patient developed severe pleural effusions and respiratory failure, underscoring the condition's potential severity.

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Area of Science:

  • Nephrology
  • Pulmonology
  • Pathology

Background:

  • Uremic pleuritis is a recognized complication in patients undergoing hemodialysis.
  • It typically presents with pleural effusions and often responds well to continued dialysis.

Observation:

  • A 61-year-old male on hemodialysis developed massive, hemorrhagic, and exudative bilateral pleural effusions.
  • These effusions were refractory to dialysis, thoracentesis, pleural biopsies, pleurodesis, and antituberculous drugs.

Findings:

  • Autopsy revealed bilateral fibrinous pleuritis without evidence of infection or malignancy.
  • The patient succumbed to respiratory failure, indicating a severe and fatal clinical course of uremic pleuritis.

Implications:

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  • This case underscores that while often manageable, uremic pleuritis can be fatal in severe, refractory cases.
  • It highlights the need for vigilance and consideration of aggressive management in such instances.