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(Chest. 1996;110:1271-1274.)
© 1996 American College of Chest Physicians

Etiology and Prognostic Significance of Eosinophilic Pleural Effusions

A Prospective Study

Jeffrey B. Rubins MD1 and Hanna Bloomfield Rubins MD, MPH2

1 From the Pulmonary Disease Veterans Affairs Medical Center, and Department of Medicine, University of Minnesota School of Medicine, Minneapolis
2 From the General Internal Medicine Divisions Veterans Affairs Medical Center, and Department of Medicine, University of Minnesota School of Medicine, Minneapolis

Study objective: To determine the diagnostic and prognostic significance of eosinophilic pleural effusions.

Design: A prospective cohort study of patients undergoing thoracentesis between September 1990 and September 1995.

Setting: A university-affiliated VA Medical Center.

Patients: Four hundred seventy-six consecutive patients.

Measurements and results: Eosinophilic pleural effusions were identified in 44 of the 476 patients (9.2%). Malignancy was diagnosed as frequently in eosinophilic as in noneosinophilic effusions (20.5% vs 20.1%). The only diagnoses that were significantly associated with eosinophilic effusions were idiopathic (25% vs 8%; p=0.001) and postthoracic surgery (11% vs 3%; p=0.023). Median survival was 7.7 months for those with a noneosinophilic effusion compared to 16.8 months for those with eosinophilia (p=0.017). This difference in survival persisted after adjustment for age and diagnois.

Conclusions: We conclude that malignancy is as prevalent among eosinophilic as noneosinophilic pleural effusions. However, the survival of patients with pleural fluid eosinophilia may be better than that of patients with noneosinophilic effusions.

Key Words: eosinophilia • pleural effusion • thoracentesis

Submitted on February 7, 1996
Accepted on April 18, 2007




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