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Abstract

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Article in Japanese

Case Report

A case of systemic lupus erythematosus with pleural effusion containing many plasma cells with elevated adenosine deaminase levels at the initial presentation

Fumiaki Mukohara  Keiichi Fujiwara  Chihiro Ando  Takamasa Nakasuka  Yoshitaka Iwamoto  Takuo Shibayama 

Department of Respiratory Medicine, National Hospital Organization Okayama Medical Center

ABSTRACT

A 45-year-old woman complaining of exertional dyspnea consulted at our hospital because of massive left pleural effusion, which contained many plasma cells with elevated adenosine deaminase (ADA) levels. No malignant cells were detected in pleural effusion. The condition progressed rapidly within only three weeks and was removed by chest drainage. Computed tomography scans of the chest showed enhanced pleural thickenings and nodules. A pathological examination of the biopsied specimen obtained by video-assisted thoracoscopic surgery showed nonspecific pleurisy with plasma cell infiltration in the pleura and arterial walls. The antinuclear antibody test result was positive, double-stranded deoxyribonucleic acid specific antibody levels were elevated, and the serum complement titer was decreased. Therefore we diagnosed the patient with systemic lupus erythematosus (SLE) accompanied by pleurisy and pleural effusion. We described an interesting case of SLE with massive and rapidly progressive unilateral pleural effusion containing many plasma cells with elevated ADA levels at the initial presentation.

KEYWORDS

Systemic lupus erythematosus (SLE)  Pleural effusion  Initial presentation  Plasma cell  Adenosine deaminase (ADA) 

Received 16 Feb 2017 / Accepted 25 May 2017

AJRS, 6(5): 393-398, 2017

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