Pleural effusion causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The most common causes of transudative pleural effusions in the United States are left ventricular failure, pulmonary embolism, and cirrhosis (causing hepatic hydrothorax), while the most 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. Although pulmonary embolism can produce either transudative or exudative pleural effusions, the latter is more common.
Causes
Common Causes
The most common causes of transudative pleural effusions in the United States are:
- Left ventricular failure
- Pulmonary embolism
- Cirrhosis (causing hepatic hydrothorax)
The most common causes of exudative pleural effusions are:
- Bacterial pneumonia
- Malignancy (Lung cancer, breast cancer, and lymphoma)
- Viral infection
- Pulmonary embolism
Other causes of pleural effusion include, tuberculosis (though pleural fluid smears are rarely positive for AFB, this is the most common cause of pleural effusion in some developing countries), autoimmune disease such as systemic lupus erythematosus, bleeding (often due to chest trauma), chylothorax (most commonly caused by trauma), and accidental infusion of fluids. Less common causes include, esophageal rupture or pancreatic disease, intraabdominal abscess, rheumatoid arthritis, asbestos pleural effusion, Meig's syndrome (ascites and pleural effusion due to a benign ovarian tumor), and ovarian hyperstimulation syndrome.
Pleural effusions may also occur through medical/surgical interventions, including the use of medications (pleural fluid is usually eosinophilic), coronary artery bypass surgery, abdominal surgery, endoscopic variceal sclerotherapy, radiation therapy, liver or lung transplantation, and intra-or extravascular 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
- Carcinomatous pleural effusion
- 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.