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At least 955 records · Page 53Linked to original sources
PubMed1990

Pleural effusion as an initial clinical presentation of myxedema: report of a case.

Myxedema causes functional derangement of various organs. However, it is rarely presented by pleural effusion. A 71-year-old man who had received radiotherapy for his nasal malignancy and left mandibular tumor developed bilateral, massive, refractory pleural effusions and respiratory embarrassment with several episodes of apnea in spite of treatment with diuretics, antibiotics, antituberculous agents, adrenal corticosteroid hormone and therapeutic thoracenteses. Definitive diagnosis was delayed until 6 months after admission. Replacement of the thyroid hormone resulted in the disappearance of the pleural effusion and the dramatic improvement of his long-time hearing impairment. Myxedema should be considered in the differential diagnosis of an unexplained pleural effusion no matter whether it is a transudate or an exudate.

Aged↗
PubMed1990

[Pleurisy in ovarian hyperstimulation syndrome. Apropos of a case].

The syndrome of ovarian hyperstimulation is a little known aetiology of pleural effusion. It should be thought of in young women who are under treatment to induce ovulation. Serous effusions which occur in these cases are a serious sign. The effusions are exudates and not transudates as occurs in Demons-Meigs syndrome. The treatment which will be undertaken ought to consider the possibility that a pregnancy is underway.

Adult↗
PubMed1989

Constrictive pericarditis presenting as pleural effusion of unknown origin.

Despite the known association of pleural effusion with constrictive pericarditis, the presentation of constrictive pericarditis as pleural effusion of unknown origin has, to our knowledge, never been described. After evaluating such a case, we retrospectively analyzed all cases of established constrictive pericarditis seen in this institution in the last six years. The clinical and laboratory features of this cohort of 30 patients are similar to those of other reported series. Pleural effusion was present in 18 (60%) of 30 cases. In six (12%) of the 18 cases, pleural effusion was a major component of the clinical presentation, and in three (10%) of these six cases, the persistence of pleural effusion of unknown origin was the indication for referral to this institution. Analysis of pleural fluid in four cases revealed three exudates and one transudate. We believe this is the first report of unexplained pleural effusion as the presenting manifestation of constrictive pericarditis, and this diagnosis should be added to the list of causes of unexplained pleural effusion.

Adolescent↗
PubMed1986

[Diagnostic value of the combined determination of carcinoembryonic antigen (CEA) in pleural effusion and serum with an enzyme immunoassay (EIA). Sensitivity, specificity and relation to tumor type].

Measurement of carcinoembryonal (CEA) levels in pleural fluid are suggested to improve the unsatisfactory sensitivity of pleural cytology in the differential diagnosis of malignant pleural effusions. We evaluated simultaneously determined pleural and serum CEA levels in 117 patients with pleural effusions of different aetiology (74 malignant, 30 inflammatory exudates and 13 transudates) by use of an enzyme immunoassay (EIA). Despite considerable scatter, pleural levels of CEA in malignant effusions were significantly higher (p less than 0.001) than the values in benign effusions. Using a cut off level of 5 ng/ml, 41% (= sensitivity) of malignant pleural effusions showed elevated concentrations of CEA. Only one out of 43 benign effusions showed a level of 5 ng/ml, which is equivalent to a specificity of 98%. However, malignant effusions due to small cell lung cancer, pleural mesothelioma and metastasising ovarian carcinoma never showed elevated levels of CEA. Highest pleural values of CEA were observed in cases of alveolar cell or adenocarcinoma of the lung or metastasising breast cancer. Although pleural and serum CEA levels correlated significantly (rs = 0.77), the evaluation of serum CEA levels alone yielded a lower sensitivity (36%) and specificity (93%) than pleural levels. 77% of cases with malignant pleural effusions showing elevated pleural CEA levels were characterized by an increased ratio Pleura/Serum greater than 1, particularly in effusions due to lung cancer. The CEA ratio was significantly higher (p less than 0.05) in patients with malignant than with benign effusions. EIA appears to be more specific by avoiding false positive results in benign effusions as compared with determination by conventional RIA. In conclusion, evaluation of pleural CEA levels in patients with malignant effusions by using an EIA because of its high specificity is a valuable adjunct to pleural cytology in improving the diagnosis of malignant effusions. However, a normal CEA level in either pleural effusion or in serum is of no clinical significance. Simultaneous measurement in pleural effusion and serum is of greater value.

Breast Neoplasms↗
PubMed1981

Levels of angiotensin-converting enzyme in pleural effusion.

The value of determining the angiotensin-converting enzyme (ACE) in serum has been clearly established, particularly in sarcoidosis, but is significance in pleural effusions is practically unknown. In the present study, ACE level was determined in the pleural fluid of 18 hospitalized patients along with the values for total protein, lactic acid dehydrogenase (LDH), complete and differential cell counts and cytology. The ACE level was higher in exudates than in transudates and paralleled closely the total protein level in the pleural fluid. There was no correlation between ACE and LDH levels and either WBC or RBC counts in the effusions. The ACE levels failed to discriminate between benign and malignant diseases or to correlate with any specific etiology for the effusion. There was a significant gradient between ACE levels that were higher in the serum than in the effusion of all nine patients in whom both were measured. The filtration coefficient (ratio of pleural fluid to serum concentration of a protein) of ACE was less than that of total protein and was compatible with ACE penetration in the pleural fluid by a process of diffusion.

Humans↗
PubMed1964

IN VITRO PHAGOCYTOSIS OF STAPHYLOCOCCUS AUREUS WITH SPECIAL REFERENCE TO A POSSIBLE ANTIPHAGOCYTIC FUNCTION OF COAGULASE.

Borchardt, Kenneth A. (Tulane University School of Medicine, New Orleans, La.), and William A. Pierce, Jr. In vitro phagocytosis of Staphylococcus aureus with special reference to a possible antiphagocytic function of coagulase. J. Bacteriol. 87:311-315. 1964.-Rabbit antisera were prepared to Staphylococcus aureus strains of bacteriophage types 81 and 42D with vaccines consisting of washed, heat-killed cells grown in media which either did or did not support coagulase formation. Partially purified coagulases were prepared, and were used to produce rabbit anticoagulase antisera. In vitro phagocytic studies, with the two staphylococcal strains plus rabbit polymorphonuclear peritoneal exudate cells and the various types of rabbit antisera, did not yield evidence that coagulase per se contributes to staphylococcal resistance to either ingestion or intracellular killing. The role of coagulase, if any, in the virulence of these organisms for rabbits (and probably for man) must therefore be attributed to some other mechanism.

Animals↗