Diagnosis and outcome of patients with idiopathic pleural effusions

Introduction: Long-term follow-up course for patients with idiopathic pleural effusions has not been established.Methods: From October 2013 to June 2021 all patients with idiopathic effusion were prospec-tively followed up with clinical examination and imaging at 1,3,6 and every 6 months for a minimum of 1 year.Results: Twenty-nine patients were diagnosed with idiopathic effusion and followed up. Mesot-helioma was detected during the follow-up in two patients at 7 and 18 months, one of whom had blood-tinged pleural fluid and the other reported a 10% weight loss. Mesothelioma was not diagnosed in any of the patients with effusion covering less than two thirds of the hemithorax, and without constitutional symptoms or a blood-tinged fluid appearance. Most of the effusions resolved or showed a clear improvement in the first six months.Conclusions: Patients without weight loss and with small, non-hematic effusions, may benefit from conservative treatment and clinical-radiological follow-up.(c) 2023 Elsevier Espana, S.L.U. and Sociedad Espanola de Medicina Interna (SEMI). All rights reserved.