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We would like to thank Dr. Böhm for her comments on our contribution (1) and the important note. Asbestos-induced pleurisy should be included in the differential diagnosis of pleural effusion. This is especially true for elderly male patients with no obvious reason for effusion, who should also be questioned about asbestos exposure in the distant past. A recent retrospective study of 11 mostly pulmonary clinics in Japan identified 110 patients with benign asbestos pleural effusion over a period of 21 years. Patients were exclusively men, with a median age of 74 years at diagnosis. The median latency to onset of pleural effusion after asbestos exposure was 48 years. Of the 110 patients, 98 had pleural plaques, and 6 (5.5%) had an additional asbestosis. None of these patients developed a pleural mesothelioma during follow-up. The criteria for diagnosis of a benign asbestos pleural effusion were:

  • history of asbestos exposure;
  • confirmation of pleural effusion by chest X-ray, computed tomography, and thoracentesis;
  • exclusion of another cause of pleural effusion (2).

Differences in the localization and extent of pleural abnormalities in computed tomography between early mesotheliomas and benign asbestos pleural effusion have been reported (3).

DOI: 10.3238/arztebl.2019.0615b

On behalf of the authors

Prof. Dr. med. Berthold Jany

Würzburg, Germany

bert.jany@t-online.de

Conflict of interest statement

The authors of both contributions declare that no conflict of interest exists.

1.
Jany B, Welte T: Pleural effusion in adults—etiology, diagnosis, and treatment. Dtsch Arztebl Int 2019; 116: 377– 86 VOLLTEXT
2.
Fujimoto N, Gemba K, Aoe K, et al.: Clinical investigation of benign asbestos pleural effusion. Pulm Med 2015; 2015: 416179 CrossRef MEDLINE PubMed Central
3.
Kato K, Gemba K, Fujimto N, et al.: Pleural irregularities and mediastinal pleural involvement in early stages of malignant pleural mesothelioma and benign asbestos pleural effusion. Eur J Radiol 2016; 85: 1594–600 CrossRef MEDLINE
1.Jany B, Welte T: Pleural effusion in adults—etiology, diagnosis, and treatment. Dtsch Arztebl Int 2019; 116: 377– 86 VOLLTEXT
2.Fujimoto N, Gemba K, Aoe K, et al.: Clinical investigation of benign asbestos pleural effusion. Pulm Med 2015; 2015: 416179 CrossRef MEDLINE PubMed Central
3.Kato K, Gemba K, Fujimto N, et al.: Pleural irregularities and mediastinal pleural involvement in early stages of malignant pleural mesothelioma and benign asbestos pleural effusion. Eur J Radiol 2016; 85: 1594–600 CrossRef MEDLINE

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