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Progressive apical pleural fibrosis: a 'constrictive' ventilatory defect.

R M Oliver1, E Neville

  • 1Department of Respiratory Medicine, St Mary's Hospital, Portsmouth, Hampshire.

British Journal of Diseases of the Chest
|October 1, 1988
PubMed
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Bilateral apical pleural fibrosis, potentially benign asbestos-related pleurisy, was observed in two patients. One patient showed improvement with steroid treatment, highlighting a characteristic 'constrictive' pulmonary function defect.

Area of Science:

  • Pulmonology
  • Occupational Medicine
  • Pathology

Background:

  • Asbestos exposure is a known cause of various pleural diseases.
  • Benign asbestos-related pleurisy (BAP) is characterized by pleural thickening without significant fibrosis.
  • Distinguishing BAP from other asbestos-related pleural conditions is crucial for accurate diagnosis and management.

Observation:

  • Two patients presented with bilateral apical pleural fibrosis.
  • This specific pattern of fibrosis was suspected to be a form of benign asbestos-related pleurisy.
  • One patient exhibited a positive response to corticosteroid therapy.

Findings:

  • The observed pulmonary function defect included reduced lung volumes.
  • A raised gas transfer coefficient was noted, indicating impaired gas exchange.

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  • This combination of findings was described as a 'constrictive' defect.

    • Implications:

    • The findings suggest that steroid-responsive apical pleural fibrosis may represent a distinct manifestation of asbestos-related pleural disease.
    • This expands the understanding of the spectrum of benign asbestos-related pleurisy.
    • Further research is warranted to confirm the etiology and optimal management of this specific condition.