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Pleural Effusion - Causes and Types-Symptoms-Diagnosis-Treatment and Complications

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Pleural Effusion - About

Pleural effusion is the accumulation of fluid in the space between the two coverings (pleura) of the lung. The ability of the lung to expand is affected.

The two layers of the pleura are separated by a virtual cavity. About 5 to 10 ml of fluid is normally present in this cavity. This allows for lung expansion, and helps maintain lung inflation. When the fluid collection exceeds the safe level, the condition is called pleural effusion. The ability of the lung to expand is affected. Pleural effusions are more common in adults when compared to children.

Causes of Pleural Effusion

Pleural Effusion is usually a complication of an underlying illness. Based on the composition of the fluid and the underlying cause, pleural effusion can be:

1)      Transudate pleural effusions;

2)      Exudate pleural effusions. 

Pleural Effusion

This classification is not absolute, but it aids in evaluation and possible diagnosis.

Conditions leading to imbalances in hydrostatic and oncotic pressure result in transudate pleural effusion. These include:

Bullet Congestive heart failure

Bullet Liver failure; Cirrhosis

Bullet Kidney failure; nephrotic syndrome

Bullet Peritoneal dialysis

Bullet Low albumin levels

Bullet Hypothyroidism

Bullet Pulmonary embolism

Bullet Mitral stenosis

In transudate pleural effusion, fluid leaks from blood vessels into the pleural space.

Exudate pleural effusions are caused by inflammation of the pleura. The pathology often traces back to the lungs. Causes include:

Bullet Malignancy (Lung cancer, Breast cancer, Lymphoma, Asbestosis Mesothelioma)

Bullet Pneumonia

Bullet Tuberculosis

Bullet Auto immune disease (Systemic Lupus Erythematosus)

Bullet Kidney failure; Uremia

Bullet Meigs’ syndrome

Bullet Pancreatitis

Bullet Ascites

Bullet Rheumatoid arthritis

Bullet Pulmonary embolism

A number of drugs like amiodarone, nitrofurantoin, phenytoin, pergolide, methotrexate, penicillamine and bromocriptine cause exudative pleural effusion rarely.

Transudate pleural effusions contain less protein and LDH (lactate dehydrogenase) than exudate pleural effusions. Light’s criteria (described later) can be used to diagnose an exudate effusion.

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