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Pou C, Ferreiro L, Suárez-Antelo J, Golpe A, Álvarez-Dobaño JM, Toubes ME, Lama A, Rodríguez-Núñez N, Ricoy J, Rábade C, Lourido T, Valdés L. Characteristics of pleural effusion due to amyloidosis. Ann Thorac Med 2023; 18:53-60. [PMID: 37323369 PMCID: PMC10263077 DOI: 10.4103/atm.atm_433_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/01/2023] [Indexed: 06/17/2023] Open
Abstract
The characteristics of patients with pleural amyloidosis (PA) are poorly known. A systematic review was performed of studies reporting clinical findings, pleural fluid (PF) characteristics, and the most effective treatment of PA. Case descriptions and retrospective studies were included. The review included 95 studies with a total sample of 196 patients. The mean age was 63 years, male/female ratio was 1.6:1, and 91.9% of patients were >50 years. The most common symptom was dyspnea (88 patients). PF was generally serious (63%), predominantly lymphocytic, and with the biochemical characteristics of transudates (43.4%) or exudates (42.6%). Pleural effusion was generally bilateral (55%) and <1/3 of the hemithorax (50%), although in 21% pleural effusion (PE) exceeded 2/3. Pleural biopsy was performed in 67 patients (yield: 83.6%; 56/67) and was positive in 54% of exudates and 62.5% of unilateral effusions. Of the 251 treatments prescribed, only 31 were effective (12.4%). The combination of chemotherapy and corticosteroids was effective in 29.6% of cases, whereas talc pleurodesis was effective in 21.4% and indwelling pleural catheter in 75% of patients (only four patients). PA is more frequent in adults from 50 years of age. PF is usually bilateral, serous, and indistinctly a transudate or exudate. A pleural biopsy can aid in diagnosis if effusion is unilateral or an exudate. Treatments are rarely effective and there may be definitive therapeutic options for PE in these patients.
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Affiliation(s)
- Cristina Pou
- Department of Pulmonology, Álvaro Cunqueiro University Teaching Hospital, Vigo, Spain
| | - Lucía Ferreiro
- Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
- Interdisciplinary Research Group in Pulmonology, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Juan Suárez-Antelo
- Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Antonio Golpe
- Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
- Interdisciplinary Research Group in Pulmonology, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - José M. Álvarez-Dobaño
- Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
- Interdisciplinary Research Group in Pulmonology, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - María Elena Toubes
- Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Adriana Lama
- Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Nuria Rodríguez-Núñez
- Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Jorge Ricoy
- Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Carlos Rábade
- Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Tamara Lourido
- Department of Pulmonology, Álvaro Cunqueiro University Teaching Hospital, Vigo, Spain
| | - Luis Valdés
- Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
- Interdisciplinary Research Group in Pulmonology, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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Anevlavis S, Varga C, Nam TH, Man RWC, Demetriou A, Jain N, Lanfranco A, Froudarakis ME. Is there any role for thoracoscopy in the diagnosis of benign pleural effusions. CLINICAL RESPIRATORY JOURNAL 2019; 13:73-81. [DOI: 10.1111/crj.12983] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 10/01/2018] [Accepted: 11/17/2018] [Indexed: 12/26/2022]
Affiliation(s)
- Stavros Anevlavis
- Department of Respiratory Medicine; University Hospital of Evros, Medical School, Democritus University of Thrace; Alexandroupolis Greece
| | - Csaba Varga
- Department of Respiratory Medicine; University Hospital of Evros, Medical School, Democritus University of Thrace; Alexandroupolis Greece
| | - Tse Hoi Nam
- Department of Respiratory Medicine; University Hospital of Evros, Medical School, Democritus University of Thrace; Alexandroupolis Greece
| | - Raymond Wong Chun Man
- Department of Respiratory Medicine; University Hospital of Evros, Medical School, Democritus University of Thrace; Alexandroupolis Greece
| | - Artemios Demetriou
- Department of Respiratory Medicine; University Hospital of Evros, Medical School, Democritus University of Thrace; Alexandroupolis Greece
| | - Nitin Jain
- Department of Respiratory Medicine; University Hospital of Evros, Medical School, Democritus University of Thrace; Alexandroupolis Greece
| | - Anthony Lanfranco
- Department of Respiratory Medicine; University Hospital of Evros, Medical School, Democritus University of Thrace; Alexandroupolis Greece
| | - Marios E. Froudarakis
- Department of Respiratory Medicine; University Hospital of Evros, Medical School, Democritus University of Thrace; Alexandroupolis Greece
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