Pleurodesis in the treatment of systemic lupus erythematosus complicated with refrac-tory pleural effusion / 军事医学

ABSTRACT

Objective To investigate the effect and feasibility of pleurodesis in the treatment of systemic lupus erythematosus(SLE)complicated with refractory pleural effusion.Methods The clinical data on four patients were diagnosed with SLE complicated with refractory pleural effusion and received pleurodesis was retrospectively analyzed.At the same time,using such terms as"lupus"and"pleural effusion",we searched English literature in Pubmed and in Wan-Fang Database of China.Results A total of 7 cases with relative complete data were found from the literature.Six patients were female,and one was male.Three cases had bilateral pleural effusion,two had left pleural effusion,and two had right pleural effusion.Then,these eleven patients were analyed together.Those patients who suffered significant dyspnea were related to chronic pleural effusion.They were all treated with a large dose of corticosteroid and immunosuppressive agents before pleurodesis,but none of the therapies was valid.They had undergone frequent multiple fluid aspirations.The total aspirated volume of one patient exceeded 80 L before pleurodesis.The patients with pleurodesis were well tolerated and had no complications after operation.There was no relapse in follow-up.After pleurodesis,the pleural effusion of all the patients was completely improved.Conclusion The clinical manifestations of refractory pleural effusion are relatively rare in patients with SLE.Drug therapy has poor effect,while traditionally used pleurodesis may be safer and preferred in such cases.It can effectively improve patients′prognosis and quality of life,but due to the small number of reported patients,the best type of intervention waits to be found.