Pleurisy: Symptom or Condition?

Jennifer Confer, PharmD, BCPS; Jennifer Egbert-Kibler, PharmD

US Pharmacist

Abstract and Introduction

Introduction

Pleurisy, also referred to as pleuritis, is an inflammation of the parietal pleura in the lungs. Clinically recognized as pain that is sharp, localized, and made worse by deep inspiration or coughing, pleurisy has a diverse array of possible causes.^[1] This article will review the physiology and generalized symptoms of pleurisy and pleuritic chest pain, as well as discuss causes and treatment options.

1 2 3 4 5 6 7

Next Section

Table 1. Potential Etiologies of Pleurisy
Toxins	Autoimmune Disorders
Asbestos Drug-induceda	Systemic lupus erythematosus Rheumatoid arthritis Sjögren's syndrome Wegener's granulomatosis
Cardiac Pulmonary embolism Myocardial infarction Pericarditis	Gastrointestinal Inflammatory bowel disease Spontaneous bacterial peritonitis
Infectious Bacterial Viral Parasitic	Hematologic Malignancy Sickle cell disease
Respiratory Pneumonia Tuberculosis pleuritis Viral pleurisy Pneumothorax	Iatrogenic Thoracentesis Chest tube insertion Thoracotomy Pleurodesis

^a See TABLE 2. Source: References 1–4, 6–9.

Table 2. Drugs Reported to Cause Pleurisy and Pleuritic Chest Pain
Cardiovascular	Chemotherapeutic Agents
Agents	Bleomycin
Amiodarone	Mitomycin
Minoxidil	Procarbazine
Bromocriptine	Methotrexate
Methysergide	Cyclophosphamide Docetaxel
Drug-InducedPleural FluidEosinophilia	Miscellaneous Agents
Nitrofurantoin	Acyclovir
Dantrolene	Clozapine
Valproic acid	D-penicillamine
Propylthiouracil	Granulocyte colony-
Isotretinoin	stimulating factor
Sclerotherapeutic Agents Sodium morrhuate/absolute alcohol	Interleukin-2 L-tryptophan Simvastatin Mesalamine Itraconazole IV immunoglobulin

Source: References 7–9.

Table 3. Therapies for Common Conditions That Result in Pleuritic Chest Pain
Condition	Treatment
Pulmonary embolism	Anticoagulation: unfractionated heparin, LMWH, fibrinolytic therapy, warfarin
Pneumothorax	Supplemental oxygen Chest tube insertion Needle decompression Pleurodesis
Myocardial infarction (NSTEMI/STEMI)	Oxygen therapy Nitrates Analgesics Antithrombotic therapy: aspirin, clopidogrel, unfractionated heparin/LMWH, glycoprotein IIb/IIIa inhibitor Beta-blockers
Pleural effusion	Oxygen therapy Diuretics (effusion due to heart failure) Thoracoscopy Antibiotics (effusion due to infection) Chest tube insertion
Pneumonia	Antibiotic therapy Supplemental oxygen Smoking cessation
Drug-induced pleural disease	Removal of offending agent NSAIDs

LMWH: low-molecular-weight heparin; NSAID: nonsteroidal anti-inflammatory drug; NSTEMI: non–STEMI; STEMI: ST-segment elevation myocardial infarction.
Source: References 2, 3, 15, 16.

Comments

Commenting is limited to medical professionals. To comment please Log-in.

Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.

processing....

Pleurisy: Symptom or Condition?

Abstract and Introduction

Introduction

Tables

Tables

Tables

References

Authors and Disclosures

Authors and Disclosures

Comments

Email This

Feedback