Aetiology, management and outcomes of eosinophilic pleural effusion: data from the International Multicentre Pleural Research Collaborative.

Krenke R., Grabczak ME., Kerkhoff J., Bielsa S., Porcel JM., Marc-Malovrh M., Rozman A., Mitchell MA., Faber K., Anevlavis S., Aujayeb A., Bodtger U., Rahman NM., Bhatnagar R., Maskell N., Mei F., Shaw JA., Walker S., Janssen JP., International Multicentre Pleural Research Collaborative .

BACKGROUND: Eosinophilic pleural effusion (EPE) is a relatively uncommon condition. The objective of this study was to evaluate the clinical, laboratory and radiological features of EPE in a multicentre cohort of patients. METHODS: This retrospective study included patients with EPE, defined as pleural fluid in which eosinophils constitute ≥10% of the total nucleated cell count, treated between 2009 and 2021 at eight respiratory centres. Predefined data were collected in the International Multicentre Pleural Research Collaborative (IMPACT) registry. RESULTS: The study included 210 patients (144 (68.6%) males), with a median age of 67 years (interquartile range (IQR) 55-78 years). Radiological evaluation showed unilateral effusion in 194 (94.2%) patients. Most EPEs (199; 95.7%) were exudates. The median pleural fluid eosinophil percentage was 23% (IQR 14.8-43.3%). The most common aetiologies were malignancy (n=61, 29%), infection (n=43, 20.5%), heart diseases/cardiac intervention (n=17, 8.1%) or trauma (n=16, 7.6%). In 42 (20%) patients, the cause of EPE remained undetermined. In univariate and multivariable analyses incorporating available clinical and laboratory data, EPE was not a significant predictor of either malignancy or benign disease. CONCLUSION: EPE is a nonspecific diagnostic entity and should not, by itself, be regarded as a relevant factor in clinical decision-making.

DOI

10.1183/23120541.01200-2025

Type

Journal article

Publication Date

2026-07-01T00:00:00+00:00

Volume

12

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