Losada Inés, González-Moreno Juan, Roda Nuria, Ventayol Lola, Borjas Yolanda, Domínguez Francisco J, Fernández-Baca Victoria, García-Gasalla Mercedes, Payeras Antoni
Internal Medicine Unit, Hospital Son Llàtzer, Palma de Mallorca, Spain.
Hospital Son Llàtzer, Hospital Son Llàtzer, Palma de Mallorca, Spain.
Intern Med J. 2018 Aug;48(8):982-987. doi: 10.1111/imj.13966.
Polyserositis (PS) is the inflammation, with effusion, of different serous membranes. It has been associated with different aetiologies, but the aetiology of PS remains unknown in a high percentage of patients.
The general objective of this retrospective study was to analyse the aetiology of PS cases seen at Son Llàtzer Hospital in an 11-year period. Other objectives were to determine the epidemiological, clinical and analytical characteristics of these patients.
An observational, descriptive and retrospective study to analyse the aetiology of PS cases seen at Son Llàtzer Hospital. The inflammation of two or more serous membranes confirmed by an imaging test was required and at least one of the serous fluid should be an exudate.
A total of 92 patients was included in the study. The most common diagnosis was neoplasm (nearly one-third of cases) followed by infectious and autoimmune diseases. PS aetiology was unknown in more than one-third. Pleura and pericardium were the most common sites of serosal involvement (83%). Antinuclear antibodies' positivity in serum and increased levels of adenosine deaminase in pleural effusion were significantly associated with a final diagnosis of autoimmune disease. Increased pleural lactate dehydrogenase levels were significantly associated with a final diagnosis of neoplasm. In 9 of 14 patients with a previous cancer, PS represented a recurrence of their cancer. Cases of unknown aetiology presented most frequently as pleural and pericardial involvement, and the majority resolved. In very few patients, an infectious aetiology could be proven.
PS is a frequent clinical entity that is associated with different diseases and its diagnosis could be challenging, with a high rate of unknown aetiologies.
多发性浆膜炎（PS）是指不同浆膜发生伴有积液的炎症。其病因多样，但在很大比例的患者中，PS的病因仍不明确。
这项回顾性研究的总体目标是分析在11年期间于Son Llàtzer医院就诊的PS病例的病因。其他目标是确定这些患者的流行病学、临床和分析特征。
一项观察性、描述性和回顾性研究，以分析在Son Llàtzer医院就诊的PS病例的病因。需要通过影像学检查确认两个或更多浆膜发生炎症，并且至少有一份浆液为渗出液。
共有92例患者纳入研究。最常见的诊断是肿瘤（近三分之一的病例），其次是感染性和自身免疫性疾病。超过三分之一的PS病因不明。胸膜和心包是最常见的浆膜受累部位（83%）。血清抗核抗体阳性和胸腔积液中腺苷脱氨酶水平升高与自身免疫性疾病的最终诊断显著相关。胸腔乳酸脱氢酶水平升高与肿瘤的最终诊断显著相关。在14例既往有癌症的患者中，有9例PS代表癌症复发。病因不明的病例最常表现为胸膜和心包受累，且大多数病例病情缓解。在极少数患者中，可以证实为感染性病因。
PS是一种常见的临床病症，与多种疾病相关，其诊断可能具有挑战性，病因不明的比例很高。
