[Pleural effusion as the presenting feature of rheumatoid disease. The value of the level of complement in the pleural fluid. A propos of 2 cases].

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.