Pleurisy with Effusion in Rheumatoid Arthritis

For almost 100 years pleurisy has been considered clinically to be one of the systemic manifestations of rheumatoid arthritis. 13,18, 22,29 Although this impression was supported by postmortem evidence, 2,3,12,14 it was not until the recent development of the technique of pleural biopsy that the diagnosis was confirmed during life. 7,17 The incidence of rheumatoid pleuritis and pleural effusion is difficult to estimate from the reports in the literature because of the difficulty of confirming this diagnosis prior to the development of the pleural biopsy technique. McCrae, 22 in 1915, reported 7 cases of acute pleurisy (one had tuberculosis) in 319 patients with rheumatoid arthritis, an incidence of approximately 2%. In a group of 510 rheumatoid arthritic patients studied by Lewis-Faning, 18 approximately 2% were found to have had pleurisy. There were 5 patients with pleurisy (1 accompanied by an effusion) in the 293 patients with rheumatoid arthritis recently reported by Short, Bauer, and Reynolds. 29 In