Cause of Asbestos-Induced Pleurisy Forgotten
Unfortunately, benign asbestos-induced pleurisy is not mentioned as a cause of pleural effusion (1). This differential diagnosis must be considered, especially for older men. Patients often cannot immediately remember being exposed to asbestos, and the answer comes after very specific questions. Pleural plaques or asbestosis may be indicative, but benign asbestos pleurisy usually occurs without further asbestos-related changes. Lengthy course, recurrent or contralateral effusion, and progression to thickening (hyalinosis complicata) or formation of rounded atelectasis are typical.
The (expired) S2 Guideline on Diagnostics and Expert Opinion of Asbestos-Related Occupational Diseases states: “The morphology is not characteristic. Diagnosis of asbestos-related pleurisy is made after exclusion of other causes of pleural effusion, including clinical parameters and history.”
Dr. med. Ellen Böhm
|1.||Jany B, Welte T: Pleural effusion in adults—etiology, diagnosis, and treatment. Dtsch Arztebl Int 2019; 116: 377–86 VOLLTEXT|