Pleurisy in Rheumatoid Arthritis

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Abstract
In 157 women and 77 men with rheumatoid arthritis, observed for a mean of 5.7 yr, the annual incidence of pleural effusion was 0.34% in the women and 1.54% in the men. In 4 pleural fluids the fluid-to-serum ratio for Waaler-Rose titers was 1:4, which agrees with the ratios for other proteins and does not suggest a pathogenetic role of the rheumatoid factor. In 2 other pleural fluids the findings suggested immune mechanisms implicating the rheumatoid factor. In general, the data, both clinical and any other, was compatible with the possibility of multiple etiological and pathogenetic factors in rheumatoid pleural effusions. These were: extrinsic factors causing pleural thickenings in 25% of nonrheumatoid men and in less than 10% of non-rheumatoid women aged more than 50 yr; preceding lung disorder; particular inflammatory responsiveness due to rheumatoid disease, related or unrelated to rheumatoid factor; and some degree of transudation.