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Updated: Jun 23, 2025

Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
Transudative pleural effusion in pleuritis associated with immunoglobulin G4-related disease diagnosed by
Yuto Kato1, Kentaro Fukunaga1, Aya Ooka1
1Department of Respiratory Medicine Koka Public Hospital Koka Japan.
Abstract:
Immunoglobulin G4 (IgG4)-related disease is a chronic inflammatory condition often characterized by exudative pleural effusions. However, transudative pleural effusions, like in the presented case of an 80-year-old man with multiple comorbidities, are less common but possible. Despite initial treatment with diuretics, the effusion persisted, prompting further investigation. Medical thoracoscopy revealed lymphatic follicle hyperplasia and an abundance of IgG4-positive plasmacytoid cells, confirming IgG4-related pleuritis. This case underscores the importance of considering inflammatory etiologies, such as IgG4-related disease, when faced with unresponsive transudative pleural effusions. Thoracoscopy serves as a valuable diagnostic tool in such scenarios, allowing for precise diagnosis and appropriate management.
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