Massive pleural effusion in systemic lupus erythematosus: thoracoscopic and immunohistological findings

Small to moderate, bilateral pleural effusions are common during the course of systemic lupus erythematosus (SLE). These are related to several complications, particularly, congestive heart failure, nephrotic syndrome, pulmonary embolism or SLE itself. Thoracoscopy performed for a massive unilateral pleural effusion in a patient with SLE and inferior vena cava thrombosis revealed several small nodules on the visceral pleura. Immunofluorescence studies of biopsy samples showed immunoglobulin deposits confirming the lupus-related origin of the pleuritis.