“Sarcoidosis as unusual cause of massive pleural effusion” Respiratory Medicine Case Reports 16 (2015) 143-145

Post Date: November 24, 2021

Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Pleural involvement is relatively rare. Development of pleural effusion in sarcoidosis needs to be evaluated for other causes, especially tuberculosis in endemic countries. Sarcoid pleural effusion responds to systemic corticosteroids. We are presenting case of 42 year old male patient of sarcoidosis who developed massive pleural effusion while on treatment with steroids, which was attributed to disease per se. Sarcoidosis as a cause of massive pleural effusion has not been mentioned before in published

A 42 year old male, nonsmoker, with no history of diabetes or hypertension, presented with 10 days history of shortness of breath which increased since 1 day. He was diagnosed as a case of sarcoidosis 2 months back based on clinical and radiologic findings when he had presented with history of intermittent fever, shortness of breath, loss of appetite and weight-loss for 2 months. Chest X Ray (CXR) done at that time showed diffuse nodular shadows (Fig. 1A). CT chest demonstrated diffuse micronodules with prediliction for fissures and bronchovascular bundles and associated mediastinal lymphadenopathy (Fig. 1B). MRI abdomen revealed multiple subcentimetric focal lesions diffusely scattered in liver, spleen and renal parenchyma. Serum angiotensin converting enzyme (ACE) was raised (126 U/L). Quantiferon Gold for tuberculosis was negative. Rheumatoid factor and anti nuclear antibodies were also negative. He was started on 40 mg of prednisolone which he was continuing till the time of present admission. He had symptomatic improvement before present episode.