Pleural effusion causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Prince Tano Djan, BSc, MBChB [2]
Overview
Common causes of transudative pleural effusion include; left ventricular failure, Nephrotic syndrome, and cirrhosis, while common causes of exudative pleural effusions are bacterial pneumonia, cancer (with lung cancer, breast cancer, and lymphoma causing approximately 75% of all malignant pleural effusions), viral infection, and pulmonary embolism. Pulmonary embolism may lead to formation of either transudate or exudate however, an exudate is commonly observed.
Causes
Causes of transudates
Most common causes
Less common causes
- Hypothyroidism
- Mitral stenosis
- Pulmonary embolism (tends to produce a comparatively small effusion but disproportionate dyspnoea and pleuritic pain; 80% are exudates, 20% are transudates).
Rare causes
- Superior vena cava obstruction (usually due to lung cancer).
- Constrictive pericarditis.
- Ovarian hyperstimulation.
- Meigs' syndrome (benign ovarian tumour, ascites and pleural effusion).
Causes of exudates
Common causes
- Bacterial pneumonia
- Malignancy (Lung cancer, breast cancer, and lymphoma)
- Pulmonary embolism
Less common causes
- Pulmonary infarction (usually resulting from pulmonary embolism).
- Autoimmune disease, especially rheumatoid arthritis and systemic lupus erythematosus
- Asbestos exposure.
- Pancreatitis.
- Complication of acute myocardial infarction (Dressler's syndrome).
- Tuberculosis (TB) (the most common cause of pleural effusion in some developing countries where TB is endemic)
Rare causes
- Yellow nail syndrome (yellow nails, lymphoedema, pleural effusion and bronchiectasis).
- Adverse drug reactions (the most common are methotrexate, amiodarone, nitrofurantoin and phenytoin).
- Fungal infections
- accidental infusion of fluids.
- esophageal rupture or pancreatic disease
- intraabdominal abscess
- radiation therapy
- operative procedures as seen in coronary artery bypass surgery, liver or lung transplantation, abdominal surgery, endoscopic variceal sclerotherapy, and insertion of central lines.
Commonly asymptomatic patients presenting with a pleural effusion
- Benign asbestos pleural effusion (BAPE)
- Hypoalbuminemia
- Nephrotic syndrome
- Peritoneal dialysis
- Rheumatoid pleurisy
- Trapped lung
- Urinothorax
- Yellow nail syndrome
Typically symptomatic patients presenting with a pleural effusion
- Bacterial pneumonia
- Pleural effusion associated with malignancy
- Congestive heart failure
- Lupus pleuritis
- Malignant mesothelioma
- Postcardiac injury syndrome (PCIS)
- Pulmonary embolism
- Tuberculous pleural effusion
- Viral pleurisy[1]
Causes by Organ System
Causes in Alphabetical Order
References
- ↑ Light, Richard J. (2007). Pleural diseases. Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 0-7817-6957-4.
- ↑ 2.0 2.1 Murray HG, Stone PR, Strand L, Flower J (1993). "Fetal pleural effusion following maternal indomethacin therapy". Br J Obstet Gynaecol. 100 (3): 277–9. PMID 8476835.
- ↑ Bartlett RP, Greipp PR, Tefferi A, Cupps RE, Mullan BP, Trastek VF (1995). "Extramedullary hematopoiesis manifesting as a symptomatic pleural effusion". Mayo Clin Proc. 70 (12): 1161–4. doi:10.1016/S0025-6196(11)63442-3. PMID 7490917.