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María Monsalud Arrebola Ramírez

Hospital Comarcal de la Axarquía

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Monday, 30 December 2019

Pleural effusion and rheumatoid arthritis: Diagnostic value of the microscopic examination of pleural fluid


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Written by Laura Sánchez Torres | Rafael Zambrana Moral | María Monsalud Arrebola Ramírez

DERRAME PLEURAL Y ARTRITIS REUMATOIDE:    VALOR DIAGNÓSTICO DEL EXAMEN MICROSCÓPICO DEL LÍQUIDO PLEURAL
Figure 1.  Cholesterol crystals in pleural fluid in light field at 400 increases to 1/10 dilution.

The image belongs to the pleural fluid (PF) of a 67-year-old man with a history of erosive rheumatoid arthritis (RA), who presented to the emergency department with progressive dyspnea. The chest radiograph performed at admission showed bilateral pleural effusion (PE), so he is admitted for complete his differential study between de novo heart failure or secondary to RA. The patient underwent four days of depletion treatment, after which control radiography showed complete resolution of the right PE and persistence of the left PE. This led to the performance of diagnostic thoracoscopy and evacuation of the persistent PE.