Department of Internal Medicine E, Meir Medical Center, Kfar Saba, Israel.
Department of Pulmonology, Meir Medical Center, Kfar Saba, Israel; Affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Sarcoidosis Vasc Diffuse Lung Dis. 2020;37(3):e2020006. doi: 10.36141/svdld.v37i3.9567. Epub 2020 Sep 30.
Systemic sclerosis (SSc) is a systemic autoimmune disease, characterized by systemic fibrosis and involvement of visceral organs. Pulmonary complications are common and a leading cause of death. Pleural effusions, however, are rare. Thoracentesis is a common procedure, performed to reveal the cause of pleural effusion or to drain it and relieve dyspnea. Although generally considered a low-risk intervention, complications of thoracentesis can lead to increased morbidity and mortality. We describe three patients with SSc and symptomatic pleural effusion who required thoracentesis. All patients deteriorated shortly after the procedure and died. We assume that patients with SSc are at high-risk to develop complications after thoracentesis, most likely due to the low compliant lungs and the low elastance of the pleura. In this population, thoracentesis should be done with high caution, while measuring the pleural pressure - invasively, or with noninvasive surrogates. Further studies are required to determine mechanisms of the complication. .
系统性硬化症（SSc）是一种系统性自身免疫性疾病，其特征为全身性纤维化及内脏器官受累。肺部并发症较为常见，是导致死亡的主要原因。然而，胸腔积液较为罕见。胸腔穿刺术是一种常见的操作，用于明确胸腔积液的病因、引流并缓解呼吸困难。尽管胸腔穿刺术通常被认为是一种低风险的干预措施，但它也可能导致并发症，从而增加发病率和死亡率。我们描述了 3 例有症状胸腔积液的 SSc 患者，他们均需要进行胸腔穿刺术。所有患者在操作后不久病情恶化并死亡。我们推测 SSc 患者在进行胸腔穿刺术后发生并发症的风险较高，这可能是由于肺顺应性降低和胸膜弹性降低所致。在该人群中，胸腔穿刺术应非常谨慎地进行，同时测量胸腔压力 - 侵入性或使用非侵入性替代方法。需要进一步的研究来确定并发症的发生机制。
