Evidence map›Paper›PMID 40809241›Full record

ReviewJournal of thoracic disease2025

IgG4-related disease and pleural effusion: a systematic review.

Honorio J Martínez-Martínez, Lucía Ferreiro, Elisa Landín, Ainoa Fanego, Roi Soto-Feijóo, María Carreiras-Cuiña, Nuria Rodríguez-Núñez, María E Toubes, Luis Valdés

Abstract readReview
In one paragraph

Review in Journal of thoracic disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Honorio J Martínez-MartínezPulmonology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
Lucía FerreiroPulmonology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
Elisa LandínPulmonology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
Ainoa FanegoPulmonology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
Roi Soto-FeijóoPulmonology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.ORCID https://orcid.org/0000-0002-8603-1259
María Carreiras-CuiñaPulmonology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
Nuria Rodríguez-NúñezPulmonology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
María E ToubesPulmonology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
Luis ValdésPulmonology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Immunoglobulin G4-related disease (IgG4-RD) is a fibroinflammatory condition that rarely affects the pleura, with pleural effusion (PE) reported in only 4% of cases. The characteristics of PE in patients with IgG4-RD are unknown. The objectives of this systematic review were to document the histological and biochemical characteristics of PF and pleural tissue, assess its clinical course, and determine the most effective treatments for the management of PE. Methods: A PRISMA literature search was conducted for published articles describing the characteristics of PE in IgG4-RD and discussing the approach to PE in this setting. Results: A total of 46 articles [55 patients and 57 pleural fluid (PF) samples] were included. Median age was 66 years (range, 28-86 years), with a male/female ratio of 2.9:1. PE was predominantly right-sided or bilateral (81.3%) and usually occupied <2/3 of the hemithorax (78.9%). PF generally had a serous appearance (84.2%) and was an exudate in 94.6% of cases with predominance (≥50%) of mononucleated cells in 96% (24/25). A predominance of eosinophils (≥10%) was observed in 40% (4/10 cases). As many as 66.7% of patients presented values of adenosine deaminase (ADA) ≥35 U/L (18/27), pH values remained within normal range 7.35-7.45 (15.4%) in only two patients. Three patients had glucose values <60 mg/dL (12.5%) and the PF of two patients was a chylothorax. Pleural biopsy was consistent with diagnosis in 95.6% of cases (43/45). In total, 92.7% of patients (51/55) received treatment with corticosteroids, and 9 (17.6%) received immunosuppressants. Of the four cases left untreated, 2 underwent chest drainage. Clinical course was benign in 97.7% of patients (43/44; a patient died of unknown causes). Conclusions: Patients with IgG4-RD and PE are usually men over 50 years of age with small/moderate, right-sided or bilateral PE. PF is most commonly a lymphocytic exudate with elevated ADA values. Pleural biopsy can help establish diagnosis. Treatment with corticosteroids, combined or not with immunosuppressants, was usually effective.

Indexed as

Immunoglobulin G4-related disease (IgG4-RD)pleural biopsypleural effusionpleural fluid (PF)systematic review

Identifiers

PMID40809241
PMCPMC12340262

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.