Rheumatoid pleuritis.

Abstract

Patients (516) with definite or classical rheumatoid arthritis were studied clinically, radiographically, and serologically. Patients (301) with degenerative joint disease were simultaneously investigated as a control group. Pleurisy was more common in the rheumatoid group, particularly in men. Pleural effusion may occur as a manifestation of rheumatoid disease. Intra-pulmonary lesions of rheumatoid origin were often present and pericarditis seemed to be an associated feature in men. Methods for early definitive diagnosis of rheumatoid pleuritis were assessed. Very low glucose levels in the pleural fluid were less frequently present than previously suggested, but pleural biopsy was helpful in 42%. In some patients the sheep cell agglutination titer was higher in the pleural fluid than in the blood. The effusions usually were benign, but were unduly persistent in 4 patients and resulted in major pleural complications in 2. Pleural effusion developing in patients with rheumatoid arthritis may most likely be due to the rheumatoid disease.