Pleural Effusions in a Series of 181 Outpatients With Sarcoidosis

Huggins, John T.; Doelken, Peter; Sahn, Steven A.; King, Lydia; Judson, Marc A.

doi:10.1378/chest.129.6.1599

Cited by 104 publications

(89 citation statements)

References 22 publications

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“…Sarcoidosis is a systemic granulomatous disorder that can involve multiple organs; however, pleural involvement is not commonly observed, with a frequency that varies from 0.7% to 20% (2)(3)(4)(5). The involvement of the pleura may present as pleural effusion, pneumothorax, pleural thickening, hydropneumothorax, trapped lung or chylothorax (2,4,5).…”

Section: Discussionmentioning

confidence: 99%

“…The involvement of the pleura may present as pleural effusion, pneumothorax, pleural thickening, hydropneumothorax, trapped lung or chylothorax (2,4,5). The pleural effusion is usually serosanguineous.…”

Section: Discussionmentioning

confidence: 99%

“…Pleural involvement in patients with sarcoidosis (excluding the subpleural nodules) is a rare manifestation of this disease (2). We herein describe two cases of histologically confirmed pleuropulmonary sarcoidosis that presented as bloody pleural effusion.…”

Section: Introductionmentioning

confidence: 91%

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Bloody Pleural Effusion -A Rare Manifestation of Sarcoidosis

et al. 2013

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Sarcoidosis is a multisystemic granulomatous disease of unknown etiology. Pleural effusion is rare in patients with sarcoidosis, occurring in 0.7% to 20% of cumulative series. Bloody pleural effusion is even more rare. We herein report two cases of sarcoidosis with bloody pleural effusion and discuss the clinical manifestations, diagnostic procedures and treatment of these cases. Sarcoidosis should be included in the differential diagnosis when bloody pleural effusions are detected. An increased level of lymphocytes and an increased ratio of CD4+/CD8+ lymphocytes in bronchoalveolar lavage fluid (BALF) are helpful for making a diagnosis of sarcoidosis. Medical thoracoscopy is helpful for determining the definitive diagnosis. Corticosteroids are an effective treatment; however, the dose should be individualized according to the treatment response.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Bloody Pleural Effusion -A Rare Manifestation of Sarcoidosis

et al. 2013

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“…Apparent pleural thickening often represents inward retraction of extrathoracic soft tissue and extrapleural fat, rather than a true pleural abnormality. Pleural involvement is rare in sarcoidosis, with pleural effusions observed in less than 5% of patients on chest radiography [7,8] and in 2.8% on ultrasonography [92]. In CT studies, pleural surface thickening is evidenced in 11-33% of patients [40,42,70] and a mild effusion in 8.2% [93].…”

Section: Pleural Involvementmentioning

confidence: 99%

Imaging of sarcoidosis of the airways and lung parenchyma and correlation with lung function

et al. 2012

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Imaging has a prominent role in the assessment of sarcoidosis diagnosis and outcome, which are extremely variable. Chest radiography staging helps predict the probability of spontaneous remission, and stage IV is associated with higher mortality. However, the reproducibility of reading is poor and changes in radiography and lung function are inconsistently correlated, which may be problematic for the monitoring of disease and treatment response. Chest computed tomography (CT) makes a great diagnostic contribution in difficult cases. Bilateral hilar lymphadenopathy with peri-lymphatic micronodular pattern is highly specific for sarcoidosis. CT is important for the investigation of pulmonary complications, including aspergilloma and pulmonary hypertension. CT improves the yield of bronchoscopy for obtaining a positive endobronchial or transbronchial biopsy. CT findings may also discriminate between active inflammation and irreversible fibrosis, with occasional influence on therapeutic decisions. Three CT patterns of fibrotic sarcoidosis are identified, with different functional profiles: predominant bronchial distortion is associated with obstruction; honeycombing is associated with restriction and lower diffusing capacity of the lung for carbon monoxide; whereas functional impairment is relatively minor with linear pattern. The clinical impact of correlations between CT severity scores and functional impairment is uncertain, except for its utility elucidating the mechanisms of airflow limitation, which include bronchial distortion, peribronchovascular thickening, air-trapping and bronchial compression by lymphadenopathy.

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“…-Pleural disease including effusion occur in only 2% of cases. Chylothorax and pneumothorax were described in case reports (Huggins et al 2006). -Large vessel (venous/arterial) involvement is the result of external compression while necrotising angiitis on small vessels raises the possibility of other vasculitides (like Wegener's disease) -Lymphangitis on lung imaging raises the possibility of malignancy.…”

Section: Complicationsmentioning

confidence: 99%