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Pleural effusion with rheumatoid arthritis.
1Department of Internal Medicine and Laboratory Medicine, USD School of Medicine, Sioux Falls.
South Dakota Journal of Medicine
|March 1, 1991
Summary
Rheumatoid arthritis can cause pleural effusions, often in middle-aged men, presenting with chest pain and shortness of breath. These effusions have unique chemical markers and can be diagnosed via rheumatoid nodules on biopsy.
Area of Science:
- Rheumatology
- Pulmonology
- Pathology
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease.
- Pleural effusions are a known, though less common, complication of RA.
Observation:
- Pleural effusions in RA predominantly affect middle-aged men.
- Symptoms commonly include pleuritic chest pain and dyspnea.
Findings:
- Rheumatoid pleural effusions exhibit distinct biochemical profiles: elevated lactate dehydrogenase (LDH), low glucose, and low pH.
- Histopathological identification of a rheumatoid nodule on pleural biopsy is pathognomonic for RA-associated pleural effusion.
Implications:
- Early recognition and diagnosis of rheumatoid pleural effusions are crucial.
- Management strategies should focus on preventing irreversible pleural fibrosis and associated respiratory compromise.