Cause of Asbestos-Induced Pleurisy Forgotten

Our plain-English summary of Cause of Asbestos-Induced Pleurisy Forgotten, by E. Böhm (Deutsches Ärzteblatt International, 2019).

The study

• Author: E. Böhm
• Journal: Deutsches Ärzteblatt International
• Published: 2019;116(37):615
• Type of article: Comment
• Read it: PubMed · Publisher · Free full text

In plain English

This item is not a research study. It is a letter to the editor from a physician in Hannover, Germany, together with a reply, commenting on a 2019 review of pleural effusion (fluid around the lungs) in adults by Jany and Welte. The letter's author pointed out that the review did not mention benign asbestos-induced pleurisy as a cause of pleural effusion, and stated that it must be considered especially in older men. The author noted that patients often do not immediately recall asbestos exposure. Pleural plaques or asbestosis may be indicative, but the condition usually occurs without other asbestos-related changes. A lengthy course, recurrent effusion or effusion on the other side, and progression to pleural thickening or rounded atelectasis are typical. Quoting an expired S2 guideline, the letter stated that diagnosis is made by excluding other causes. The review's authors agreed that the condition should be part of the differential diagnosis. They also described a retrospective study from Japan of 110 patients with the condition. Those figures belong to that study, not to this correspondence.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Letter to the editor (correspondence) with a reply from the authors of the article being discussed; no original data
• Who was studied: No patients were studied. The letter came from a physician in Hannover, Germany, and commented on a 2019 review article on pleural effusion in adults by Jany and Welte. Those authors replied.
• Exposure: Asbestos exposure in general; no fiber types, products or jobs are named
• Main results:
  • No study findings. The letter's author stated that benign asbestos-induced pleurisy must be considered as a differential diagnosis, especially for older men
  • The letter's author stated that pleural plaques or asbestosis may be indicative, but that benign asbestos pleurisy usually occurs without other asbestos-related changes
  • The letter's author described typical features: a lengthy course, recurrent or contralateral (other-side) effusion, and progression to thickening (hyalinosis complicata) or rounded atelectasis
  • The letter quoted an expired S2 guideline stating that diagnosis is made after other causes of pleural effusion are excluded
  • Described in the reply, from a separate study, not a finding of this article: a retrospective study of 11 mostly pulmonary clinics in Japan identified 110 patients with benign asbestos pleural effusion over 21 years. All were men, with a median age of 74 years at diagnosis.
  • From the same separate Japanese study, as described in the reply: the median latency from asbestos exposure to onset of pleural effusion was 48 years
  • From the same separate Japanese study, as described in the reply: of the 110 patients, 98 had pleural plaques and 6 (5.5%) also had asbestosis. None developed pleural mesothelioma during follow-up.
• The authors' conclusion: The authors of the original review agreed that asbestos-induced pleurisy should be included in the differential diagnosis of pleural effusion

Topics

The National Library of Medicine indexes this study under subjects our site covers: Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: Pleurisy.

Related studies

• Pathogenesis of pleurisy, pleural fibrosis, and mesothelial proliferation — A. Herbert (1986)
• Evidence of a role for mesothelial cell-derived interleukin 8 in the pathogenesis of asbestos-induced pleurisy in rabbits — A.M. Boylan, C. Rüegg, et al. (1992)
• Diagnostic accuracy and safety of semirigid thoracoscopy in exudative pleural effusions in Denmark — F. Willendrup, U. Bodtger, et al. (2014)
• Ventilatory failure due to asbestos pleurisy — A. Miller, A.S. Teirstein, et al. (1983)
• Acute pleurisy in asbestos exposed persons — G.K. Sluis-Cremer, I. Webster (1972)
• Benign asbestos pleurisy in the rabbit. A model for the study of pathogenesis — B.L. Shore, C.C. Daughaday, et al. (1983)

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