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Pleural Effusion II: Symptoms and Management

Pleural Effusion II: Symptoms and Management

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Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion

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Pleural Effusion in Multiple Myeloma: Characteristics and Practice Patterns.

Ja Min Byun¹, Ki Hwan Kim, In Sil Choi

¹Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea.

Acta Haematologica

|August 11, 2017

Summary

Multiple myeloma patients with pleural effusion often have treatable causes like infection. Diagnostic procedures for pleural effusion in these patients are underutilized, hindering optimal care.

Keywords:

Multiple myeloma Myelomatous effusion Pleural effusion Practice pattern Tuberculosis

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Area of Science:

Oncology
Pulmonology
Infectious Diseases

Background:

Multiple myeloma (MM) patients face diagnostic challenges with pleural effusion (PE), especially in Asian countries with a double burden of diseases.
PE in MM can stem from various causes, including infections and reactive processes, complicating diagnosis and treatment.

Purpose of the Study:

To analyze the clinical features and practice patterns of multiple myeloma patients presenting with pleural effusion.
To evaluate the diagnostic approaches and the utilization of invasive procedures for PE in MM patients.

Main Methods:

A multicenter retrospective study of newly diagnosed MM patients between January 2011 and December 2015.
Analysis of 80 MM patients with PE, examining causes, diagnostic methods, and treatment patterns.

Main Results:

Parapneumonic effusion was the most common cause (25%), followed by reactive effusion (18.8%). Higher CRP and leukocytosis indicated parapneumonic PE.
Myelomatous PE occurred in 8.8% and tuberculosis in 2.5%. Invasive procedures were underutilized, with 24 patients treated empirically.
Diagnostic workup varied, with CT scans and thoracentesis/biopsy used in a subset of patients.

Conclusions:

Practice patterns reveal suboptimal use of invasive procedures for diagnosing PE in MM patients.
Reversible causes and tuberculosis pleurisy are significant considerations, necessitating active incorporation of invasive diagnostic methods.
Improved diagnostic strategies are crucial for effective management of pleural effusion in multiple myeloma.