Non-specific pleuritis: long-term follow-up outcomes

ABSTRACT

Background

The definitive etiology of nonspecific pleuritis (NSP), the influence of the type of pleural biopsy on clinical results and the minimum duration of follow-up is controversial.

Research design and methods

A retrospective, observational study of patients ≥ 18 years with NSP confirmed by closed pleural biopsy (CPB), local anesthesia pleuroscopy (LAP), or video-assisted thoracic surgery (VATS).

Results

A total of 167 patients were included (mean follow-up, 14.4 months), of which 25 (15%) were diagnosed within one month; [15 (60%) malignant]. Of the remaining 142 pleural effusions (PEf), 69 (48.6%) were idiopathic; 49 (34.5%) not-malignant and 24 (16.9%) malignant (4 mesotheliomas and 20 metastasic). The diagnosis of NSP was established by CPB (7; median time to diagnosis, 9.4 months), LAT (5; 15.8 months), and VATS (8; 13.5 months) (p = 0.606). Sixty-eight patients (40.7%) died during follow-up (mean time, 12 months).

Conclusions

In a substantial percentage of patients diagnosed with NSP, a definitive diagnosis will not be obtained, a relevant number of patients will develop a malignant PEf. The diagnostic procedure used for the diagnosis of NSP does not seem to influence delay in the diagnosis of malignant PEf. The data obtained suggest that follow-up should be maintained for at least 24 months.

KEYWORDS:

• Non-specific pleuritis
• malignant pleural effusion
• pleural biopsy
• long-term follow-up
• pleural effusion

Abbreviations

CBP	=	close pleural biopsy
LAT	=	local anesthetic thoracoscopy
NSP	=	nonspecific pleuritis
PEf	=	pleural effusion
PF	=	pleural fluid
PM	=	pleural mesothelioma
VATS	=	video-assisted thoracic surgery

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

A reviewer on this manuscript has disclosed that one of their papers is referenced.

Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Author contributions

L Ferreiro, Author and drafting. Conception and design. Approval of the final manuscript.

E Landín Rey, Co-author. Acquisition of data. Writing of the work and critical review. Approval of the final manuscript.

M Carreiras Cuina, Co-author. Acquisition of data. Writing of the work and critical review. Approval of the final manuscript.

F Gude, Co-author. Analysis and interpretation of data. Writing of the work and critical review. Approval of the final manuscript.

J R. Antúnez, Co-author. Analysis and interpretation of data. Writing of the work and critical review. Approval of the final manuscript.

J Suárez-Antelo, Co-author. Interpretation of data. Writing of the work and critical review. Approval of the final manuscript.

M E Toubes, Co-author. Interpretation of data. Writing of the work and critical review. Approval of the final manuscript.

N Rodríguez-Núñez, Co-author. Interpretation of data. Writing of the work and critical review. Approval of the final manuscript.

A Golpe, Co-author. Interpretation of data. Writing of the work and critical review. Approval of the final manuscript.

V Riveiro, Co-author. Interpretation of data. Writing of the work and critical review. Approval of the final manuscript.

L Valdés, Author and drafting. Conception and design. Approval of the final manuscript.

Additional information

Funding

This paper was not funded.