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Pulmonary Sarcoidosis Associated With Pleural Effusion: A Case Report
Shpëtim Thaçi1, Berat Krasniqi1, Arben Redjepi2
1Faculty of Medicine University of Prishtina Prishtina Kosovo.
Respirology Case Reports
|June 8, 2026
Summary
Sarcoidosis-associated pleural effusion (SAPE) is rare. This case study details a young male with bilateral pleural effusion, diagnosed via EBUS-TBNA and confirmed by elevated biomarkers, who responded well to corticosteroids.
Area of Science:
- Pulmonology
- Internal Medicine
- Rheumatology
Background:
- Sarcoidosis is a multisystem granulomatous disease primarily affecting lungs and lymph nodes.
- Pleural involvement, specifically sarcoidosis-associated pleural effusion (SAPE), is an uncommon manifestation, occurring in about 1% of cases.
- This report focuses on a rare presentation of sarcoidosis involving the pleura.
Purpose of the Study:
- To describe a rare case of sarcoidosis presenting as bilateral pleural effusion in a young adult male.
- To emphasize the diagnostic challenges and the importance of a comprehensive approach in identifying SAPE.
- To highlight the effectiveness of corticosteroid therapy in managing this rare condition.
Main Methods:
- A comprehensive diagnostic evaluation was performed, including imaging, fluid analysis, and tissue biopsy.
- Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) was utilized for tissue sampling.
- Laboratory investigations included serum angiotensin-converting enzyme (ACE), soluble interleukin-2 receptor (sIL-2R), and serum amyloid A (SAA) levels.
Main Results:
- The patient presented with bilateral pleural effusion and mediastinal lymphadenopathy.
- Pleural fluid analysis revealed a lymphocyte-predominant exudative effusion with negative microbiological and cytological results.
- EBUS-TBNA confirmed non-caseating granulomas, indicative of sarcoidosis. Elevated ACE, sIL-2R, and SAA supported active disease.
- The patient achieved complete remission with systemic corticosteroid therapy.
Conclusions:
- Sarcoidosis-associated pleural effusion is a rare but significant clinical entity.
- A meticulous diagnostic workup, integrating clinical, radiological, and histopathological findings, is crucial for accurate diagnosis.
- Systemic corticosteroids are an effective treatment for sarcoidosis-associated pleural effusion, leading to complete remission.
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