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Tuesday, December 10, 2013
Pleural Effusion with Abnormal Tests
What could pleural effusion along with an increased CRP, increased RDW and increased sed. rate mean? Heart ejection fraction is 65-70%.
An increased RDW is very non-specific and probably not related to the effusion. An increased sed rate and CRP are non-specific indicators of inflammation and can be seen with many conditions.
There are many, many causes of pleural effusions including inflammation (for example, rheumatoid arthritis), infection (for example, tuberculosis), cancer, pulmonary emboli, and many others. Although heart failure can cause pleural effusions, they are less likely when there is a normal ejection fraction. If the effusion is large enough, the usual first step is a thoracentesis where a needle is inserted into the pleural space to remove some of the fluid for analysis.
James N Allen, Jr, MD
Clinical Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University