Pauli G, Pasquali J L, Jory A, Kopferschmitt-Kubler M C, Hauptmann G, Roegel E
Poumon Coeur. 1981;37(3):213-7.
The authors report two cases of rheumatoid pleural effusion where the pleural syndrome preceded the joint manifestations. From a clinical standpoint, there was an effusion of moderate volume, pseudo-purulent in one case and straw coloured in the other. Signs of rheumatoid arthritis developed after a period of seven weeks in the first case and after a few days only in the second. Amongst the various characteristics of the pleural fluid which were analysed, the authors noted the value of a fall in glucose level, the lack of specificity of anti-gamma globulin factors, and the diagnostic value of the fall in pleural complement and its fractions. In view of the difficulty in obtaining specific histological proof by pleural biopsy, the reduced complement level is of valuable assistance in the aetiological diagnosis of rheumatoid pleural effusion, exceptional as a presenting feature.
作者报告了两例类风湿性胸腔积液病例，其中胸膜综合征先于关节表现出现。从临床角度来看，两例均有中等量胸腔积液，一例为假脓性，另一例为草黄色。第一例在七周后出现类风湿性关节炎体征，第二例仅在几天后就出现了。在分析的胸腔积液的各种特征中，作者注意到葡萄糖水平下降的价值、抗γ球蛋白因子缺乏特异性以及胸腔补体及其组分下降的诊断价值。鉴于通过胸膜活检获得特异性组织学证据存在困难，补体水平降低对类风湿性胸腔积液的病因诊断有重要帮助，类风湿性胸腔积液作为首发特征较为罕见。
