Pleuritis & Rheumatic Disease 4.25/5 (4)

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RA pleuritis

Pleuritis with fluid in right lung (left of image) at Arthritis (RA). Yokosuka T, 2013. CC BY NC SA 3.0

Interstitial lung disease: Please read here (in Danish)

Pleuritis (pneumonia) «water on the lungs»

Pleural fluid is water on the lung and can be divided into two types depending on protein content

  • Exudate with high protein levels (more than 30g / L) typical of pulmonary and / or pleural disease
  • Transudate (Protein less than 25 g / L) that may indicate heart failure or low albumin / protein in kidney disease or liver cirrhosis

Rheumatic diseases with pleuritis:

Other diseases that cause pleuritis

 Medical examinations by Pleuritis

  • Clinical examination may detect rubbing noise (early in the course of the course). Reduced respiratory noise over the lung later on in the course of occurrence of pleural effusion
  • Ultrasound, X-ray or CT examinations can show increased fluid around the lungs detected more accurately
  • For diagnostic pleural fluid tapping, investigate:
    • Blood in the pleural fluid can be a sign of cancerous disease or damage to the sting. The fluid should then be examined for any cancerous cells
    • Bacterial growth of pleural fluid is made if suspected of tuberculosis and other infections

Treatment of pleuritis by RA or SLE

  • Mild cases of pleurisy pain: NSAID (not used for concomitant severe kidney disease)
  • Moderate symptoms: Prednisone 20mg / day in a gradually reduced dose over 2-3 weeks
  • Serious: methylprednisolone (SoluMedrol) intravenously followed by Prednisolone in gradual reduced dose. Consider azathioprine (Imurel) in the long term

Similar conditions (differential diagnoses)

  • Hemothorax
    • Blood in the pleura caused by injury, rupture of adherence, pulmonary infarction, anticoagulation, endometriosis, cancer
  • Chylothorax
    • Lymphoma of the pleura by injury, cancer, hyperlipemia

Lung disease in rheumatic diseases

Grans Compendium in Rheumatology

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