TITLE:
Recurrent Pleural Effusion: Not Tuberculosis and Not a Malignancy Either
AUTHORS:
Arnil J. Doebar, Rakesh Bansie, Dasten Smit, Pieter Voigt, Mikel Chan, Iswardath Thakoer, Fitzgerald A. Gopie
KEYWORDS:
Pleural Effusion, Pancreatitis, IgG4 Related Disease, Tuberculosis
JOURNAL NAME:
Journal of Tuberculosis Research,
Vol.14 No.1,
January
15,
2026
ABSTRACT: A 47-year-old male with signs of metabolic syndrome, tobacco exposure of 3 pack years and a medical history of pancreatitis and myocardial infarction presented with unilateral pleural fluid which evolved to recurrent sometimes bilateral pleural fluid. Despite rigorous diagnostic efforts a clear diagnosis could not be established. Eventually on an abdominal ultrasound pancreatic abnormality was detected leading to a suspected diagnosis of autoimmune pancreatitis and giving way to a diagnosis of pleurisy due to Immunoglobulin G4 Related Disease (IgG4 RD) based on the 2019 ACR/EULAR classification criteria for IgG4 RD. Treatment with corticosteroids followed by rituximab resulted in sustained resolution of the pleural fluid and patient improvement.