Investigation and outcomes in patients with non-specific pleuritis: Results from the International Collaborative Effusion (ICE) database
- Anand Sundaralingam1⇑,
- Avinash Aujayeb2,
- Karl A. Jackson2,
- Emilia I. Pellas2,
- Irfan I. Khan2,
- Muhammad T. Chohan2,
- Roos Joosten3,
- Anton Boersma3,
- Jordy Kerkhoff3,
- Silvia Bielsa4,
- Jose M. Porcel4,
- Ales Rozman5,
- Mateja Marc-Malovrh5,
- Hugh Welch6,
- Jenny Symonds6,
- Stavros Anevlavis7,
- Marios Froudrakis7,
- Federico Mei8,
- Lina Zuccatosta8,
- Stefano Gasparini8,
- Francesca Gonnelli8,
- Inderdeep Dhaliwal9,
- Michael A. Mitchell9,
- Katrine Fjaellegaard10,
- Jesper K. Petersen10,
- Mohamed Ellayeh11,
- Najib M. Rahman12,
- Tom Burden13,
- Uffe Bodtger10,
- Coenraad F.N. Koegelenberg14,
- Nick A. Maskell15,
- Julius Janssen3 and
- Rahul Bhatnagar15
- 1Oxford Pleural Unit, Oxford Centre for Respiratory Medicine, Oxford, United Kingdom
- 2Northumbria Healthcare NHS Trust, North Shields, United Kingdom
- 3Department of Pulmonary diseases B70, Canisius Wilhelmina Ziekenhuis, Nijmegen, Netherlands
- 4Pleural Medicine Unit, Department of Internal Medicine, Arnau de Vilanova University Hospital, IRB Lleida, Lleida, Spain
- 5University Clinic Golnik, Golnik, Slovenia
- 6Southmead Hospital, Bristol, United Kingdom
- 7Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
- 8Respiratory Disease Unit, Department of Internal Medicine, University Hospital, Ancona, Italy
- 9Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- 10Respiratory Research Unit PLUZ, Dep. of Respiratory Medicine, Zealand University Hospital, Naestved, Denmark
- 11Mansoura University, Mansoura, Egypt
- 12Oxford Respiratory Trials Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- 13Respiratory Medicine Department, Royal Devon and Exeter Hospital, Exeter, United Kingdom
- 14Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- 15Academic Respiratory Unit, Bristol Medical School: Translational Health Sciences, University of Bristol, Bristol, United Kingdom
- Corresponding author: Anand Sundaralingam (Anand.Sundaralingam{at}ouh.nhs.uk)
Abstract
Introduction We present findings from the International Collaborative Effusion database, an ERS clinical research collaboration. Non-specific pleuritis (NSP) is a broad term that describes chronic pleural inflammation. Various aetiologies lead to NSP, which poses a diagnostic challenge for clinicians. A significant proportion of patients with this finding eventually develop a malignant diagnosis.
Methods 12 sites across 9 countries contributed anonymised data on 187 patients. 175 records were suitable for analysis.
Results The commonest aetiology for NSP was recorded as Idiopathic (80/175, 44%). This was followed by pleural infection (15%), benign asbestos disease (12%), malignancy (6%) and cardiac failure (6%). The malignant diagnoses were predominantly mesothelioma (6/175, 3.4%) and lung adenocarcinoma (4/175, 2.3%). The median time to malignant diagnosis was 12.2 months (range 0.8–32). There was a signal towards greater asbestos exposure in the malignant NSP group compared to the benign group (0.63 versus 0.27, p=0.07). Recurrence of effusion requiring further therapeutic intervention, nor initial biopsy approach were associated with a false negative biopsy. A computed tomography finding of a mass lesion was the only imaging feature to demonstrate a significant association (0.18 versus 0.01, p=0.02), though sonographic pleural thickening also suggested an association (0.27 versus 0.09, p= 0.09).
Discussion This is the first multi-centre study of NSP and its associated outcomes. Whilst some of our findings are reflected by the established body of literature, other findings have highlighted important areas for future research, not previously studied in NSP.
Footnotes
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Conflict of interest: Coenraad F.N. Koegelenberg declares honoraria for lectures from AstraZeneca and GlaxoSmithKline, in the 36 months prior to manuscript submission.
Conflict of interest: All other authors declare no competing interests.
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- Received November 8, 2022.
- Accepted January 4, 2023.
- Copyright ©The authors 2023
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