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Pleurisy

Inflammation of the pleura. It is usually caused by infections. Chest pain while breathing or coughing is the presenting symptom.

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

About Pleurisy

Pleurisy (PLUR-ih-se) is a condition in which the pleura is inflamed. The pleura is a membrane that consists of two large, thin layers of tissue. One layer wraps around the outside of your lungs. The other layer lines the inside of your chest cavity.

Between the layers of tissue is a very thin space called the pleural space. Normally this space is filled with a small amount of fluid—about 4 teaspoons full. The fluid helps the two layers of the pleura glide smoothly past each other as you breathe in and out.

Pleurisy occurs if the two layers of the pleura become irritated and inflamed. Instead of gliding smoothly past each other, they rub together every time you breathe in. The rubbing can cause sharp pain.

Many conditions can cause pleurisy, including viral infections. NIH - National Heart, Lung, and Blood Institute

What works? Research summarized

Evidence reviews

Diagnostic accuracy of T-cell interferon-gamma release assays in tuberculous pleurisy: a meta-analysis

BACKGROUND AND OBJECTIVE: The diagnosis of tuberculous pleurisy by analysis of pleural fluid using standard diagnostic tools is difficult. Recently, T-cell interferon-γ release assays (IGRA) have been introduced for the diagnosis of tuberculous pleurisy. The aim of the present meta-analysis was to establish the overall diagnostic accuracy of IGRA on both pleural fluid and peripheral blood, for diagnosing tuberculous pleurisy.

Diagnosis of tuberculosis pleurisy with adenosine deaminase (ADA): a systematic review and meta-analysis

This systematic review and meta-analysis was performed to determine accuracy and usefulness of adenosine deaminase (ADA) in diagnosis of tuberculosis pleurisy. Medline, Google scholar and Web of Science databases were searched to identify related studies until 2014. Two reviewers independently assessed quality of studies included according to standard Quality Assessment of Diagnosis Accuracy Studies (QUADAS) criteria. The sensitivity, specificity, diagnostic odds ratio and other parameters of ADA in diagnosis of tuberculosis pleurisy were analyzed with Meta-DiSC1.4 software, and pooled using the random effects model. Twelve studies including 865 tuberculosis pleurisy patients and 1379 non-tuberculosis pleurisy subjects were identified from 110 studies for this meta-analysis. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnosis odds ratio (DOR) of ADA in the diagnosis of tuberculosis pleurisy were 45.25 (95% CI 27.63-74.08), 0.86 (95% CI 0.84-0.88), 0.88 (95% CI 0.86-0.90), 6.32 (95% CI 4.83-8.26) and 0.15 (95% 0.11-0.22), respectively. The area under the summary receiver operating characteristic curve (SROC) was 0.9340. Our results demonstrate that the sensitivity and specificity of ADA are high in the diagnosis of tuberculosis pleurisy especially when ADA≥50 (U/L). Thus, ADA is a relatively sensitive and specific marker for tuberculosis pleurisy diagnosis. However, it is cautious to apply these results due to the heterogeneity in study design of these studies. Further studies are required to confirm the optimal cut-off value of ADA.

Diagnostic value of interferon-gamma in tuberculous pleurisy: a metaanalysis

This review assessed the accuracy of interferon-gamma in pleural effusions for the diagnosis of tuberculous pleurisy. The authors concluded that it is a sensitive and specific test. The review suffered from limitations relating to the literature search, quality assessment and synthesis, and very few individual study details were presented. These findings should therefore be interpreted with extreme caution.

See all (11)

Summaries for consumers

No clear evidence that corticosteroids are effective for tuberculous

Tuberculous pleural effusion results from tuberculous infection of the membrane covering of the lungs. This results in a build up of fluid around the lung that impairs breathing and may lead to restriction of lung function in the long term. Some clinicians believe that corticosteroids used in combination with antituberculous drugs can help to prevent these complications. We found no clear evidence supporting the use of corticosteroids in people with tuberculous pleural effusion, regardless of HIV status. However, only one trial evaluated the balance between benefit and harm of corticosteroids in people infected with HIV.

Terms to know

Body Membrane
A very thin layer of tissue that covers a surface.
Cough
A cough is a natural reflex that protects your lungs. Coughing helps clear your airways of lung irritants, such as smoke and mucus (a slimy substance).
Infection
The invasion and growth of germs in the body. The germs may be bacteria, viruses, yeast, fungi, or other microorganisms.
Inflammation
Redness, swelling, pain, and/or a feeling of heat in an area of the body. This is a protective reaction to injury, disease, or irritation of the tissues.
Lungs
One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.
Pleura
A thin layer of tissue that covers the lungs and lines the interior wall of the chest cavity. It protects and cushions the lungs. This tissue secretes a small amount of fluid that acts as a lubricant, allowing the lungs to move smoothly in the chest cavity while breathing.
Thorax
Having to do with the chest.
Tissue
A group of cells that act together to carry out a specific function in the body. Examples include muscle tissue, nervous system tissue (including the brain, spinal cord, and nerves), and connective tissue (including ligaments, tendons, bones, and fat). Organs are made up of tissues.

More about Pleurisy

Photo of an adult

Also called: Pleuritis

See Also: Pneumothorax, Hemothorax, Pleural Effusion

Other terms to know: See all 8
Body Membrane, Cough, Infection

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