Any suggestions for chronic pleuritis with fibrosis?
Patient: 6/12: diagnoses - hospitalized with chronic severe gastroenteritis, asymptomatic for bilateral pleural effusions. Rt lung drained approx 425cc; transudate. 7/12: diagnoses - gall bladder attack; multiple DVTs & simultaneously multiple bilateral pleural emboli. Tested positive for primary onset of APS: antiphospholipid syndrome. Began anticoagulant therapy. 8/12: diagnosis - removal of gall bladder 11/12: diagnosis - non alcoholic fatty liver disease, liver infection & extremely high liver enzymes. NOS all B vitamin anemia & NOS iron anemia. 3/13: diagnosis - shortness of breath, rt pleural effusion, approx 400cc drained; transudate. 9/13: diagnosis - difficulty breathing, rt pleural effusion, approx 450cc drained; transudate. 12/13: diagnosis - shortness of breath, rt pleural effusion; wait to see. 1/14: diagnosis - symptomatic chest pain, diff breathing, rt pleural effusion; VATS thoracentisis & pleural biopsies. Pathology final diagnosis: chronic pleuritis with fibrosis. NO MALIGNANCY. O2 since 12/10. 12/13 Renexa 500 mgs/2x day & breathing treatments PRN. 11/12 Famotidine for acid reduction. Immunosuppressants do not work. Any suggestions? Doctor: Hello,  It is hard for me to say exactly what is wrong with the current treatment. However, I recommend you to consult your treating doctor if you are feeling not comfortable.   Hope I have answered your query. Let me know if I can assist you further.   Regards, Dr. Jnikolla,  Pulmonologist