Department of Respiratory Disease, The State Key Laboratory of Respiratory Disease, China Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120, Guangdong Province, China.
Department of Cardiothoracic Surgery, The State Key Laboratory of Respiratory Disease, China Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120, Guangdong Province, China.
BMC Pulm Med. 2020 Apr 3;20(1):82. doi: 10.1186/s12890-020-1108-z.
Eosinophilic pleural effusion (EPE) is attributed to several well-recognised causes. However, some patients remain idiopathic, even after thorough clinical work-up. The present study aimed to better characterize idiopathic EPE (IEPE) and to outline the diagnostic procedure for this disease.
Complete clinical data of 11 consecutive patients with IEPE were prospectively collected and analysed. Preliminary diagnostic procedure of IEPE in our hospital was performed.
All the 11 patients had respiratory symptoms and unilateral pleural effusion (PE) occurred in 4 patients. The mean percentage of eosinophils in PE was 22.4% (range, 12.4-50.5%). Lactate dehydrogenase, adenosine deaminase, proteins and carcinoembryonic antigen in PE were 246.0 U/L (range, 89.8-421.9 U/L), 13.8 U/L (range, 1.8-24.0 U/L), 42.6 g/dl (range, 32.8-52.6 g/dl) and 2.17 mg/mL (range, 0.46-4.31 mg/mL), respectively. Parasite-specific IgG antibody in blood and parasite eggs in stool were both negative. No evidence of tuberculosis or malignancy was observed in pleural biopsy. Symptoms and abnormal pulmonary imaging were eliminated after glucocorticoid use.
IEPE is a diagnosis of exclusion. Patients with EPE without a clear cause should be asked to provided complete medical, surgical and drug-related histories. A thorough work-up is essential. Moreover, we recommend follow-up after the use of glucocorticoid until effusion resolves.
GYFYY. Registration No: GYFYY20150901221. Registered time: 1 September 2015. Date of enrolment of the first participant to the trial: 22 January 2016.
嗜酸性胸腔积液（EPE）归因于一些公认的原因。然而，一些患者即使经过彻底的临床检查，仍然是特发性的。本研究旨在更好地描述特发性 EPE（IEPE）并概述该疾病的诊断程序。
前瞻性收集并分析了 11 例连续的 IEPE 患者的完整临床数据。对我院 IEPE 的初步诊断程序进行了分析。
所有 11 例患者均有呼吸道症状，4 例出现单侧胸腔积液（PE）。胸腔积液中嗜酸性粒细胞的平均百分比为 22.4%（范围 12.4-50.5%）。胸腔积液中的乳酸脱氢酶、腺苷脱氨酶、蛋白和癌胚抗原分别为 246.0 U/L（范围 89.8-421.9 U/L）、13.8 U/L（范围 1.8-24.0 U/L）、42.6 g/dl（范围 32.8-52.6 g/dl）和 2.17 mg/mL（范围 0.46-4.31 mg/mL）。血液中寄生虫特异性 IgG 抗体和粪便中寄生虫卵均为阴性。胸腔活检未发现结核或恶性肿瘤的证据。使用糖皮质激素后，症状和异常肺部影像得到消除。
IEPE 是一种排除性诊断。对于没有明确病因的 EPE 患者，应详细询问其医疗、手术和药物相关病史。彻底的检查是必不可少的。此外，我们建议在使用糖皮质激素后进行随访，直到胸腔积液消退。
GYFYY。注册号：GYFYY20150901221。注册时间：2015 年 9 月 1 日。试验首例患者入组时间：2016 年 1 月 22 日。
