Abstract
A 56-year-old, non-smoker male with no exposure, presented with right chest pain and a huge loss in forced vital capacity due to right lung volume reduction with consensual pleural thickening on high-resolution computed tomography. All serological and microbiological tests were negative. The surgical lung biopsy showed fibrinous pleurisy while the search for neoplastic cells resulted negative. Because of symptoms worsening he started low dose steroids without benefits until he died 3 months later for cardiac ischemic attack. We reviewed the literature to identify possible etiologies and a rapidly progressive idiopathic pleurisy revealed to be the most probable diagnosis.
Highlights
We present a case of idiopathic fibrinous pleurisy affecting a 56-year-old non-smoker male that has shown a rapidly progressive course
Autoimmune and microbiological tests resulted negative, so he underwent plain and contrast enhanced computed tomography (CT) that revealed a slight reduction in right lung volume with associated right pleural effusion and pleural thickening (Fig. 2)
The natural history of this frustrating condition still remains poorly understood [1, 4]. With this case report we present the onset and evolution of unilateral idiopathic fibrinous pleurisy, whose description might contribute to better characterize the spectrum presentation of this peculiar condition
Summary
We present a case of idiopathic fibrinous pleurisy affecting a 56-year-old non-smoker male that has shown a rapidly progressive course. A 56-year-old non-smoker male, engineer for a gas company, presented in early January 2017 with right chest pain and a 1.56 L (29.4%) loss in forced vital capacity (FVC) over the previous 3 years. A chest X-ray (CXR) was performed and showed a considerable reduction in the right lung volume with associated right pleural effusion (Fig. 1). Autoimmune and microbiological tests resulted negative, so he underwent plain and contrast enhanced computed tomography (CT) that revealed a slight reduction in right lung volume with associated right pleural effusion and pleural thickening (Fig. 2). Autopsy excluded mesothelioma or other pleural neoplastic diseases, but reported the presence of diffuse fibrinous pleurisy with collagen deposition
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