serositis

Serositis is inflammation of the serous membranes lining the pleural, pericardial, and peritoneal cavities. It can cause pain and effusions and is often part of systemic diseases but may result from infection, drugs, or metabolic disorders. The main manifestations are pleuritis (pleura), pericarditis (pericardium), and peritonitis (peritoneum), which may occur alone or together.

Common causes include autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis, infectious diseases (including tuberculosis), malignancy, uremia, and certain drugs. Postoperative inflammatory states can also trigger serositis.

Clinical features vary by membrane involved. Pleuritis presents with sharp, usually pleuritic chest pain and may produce pleural effusion. Pericarditis causes chest pain that improves with sitting up or forward bending and may have a pericardial rub or effusion. Peritonitis presents with abdominal pain and sometimes ascites. Fever and malaise may accompany inflammatory serositis.

Diagnosis combines history, examination, and imaging. Echocardiography detects pericardial effusion; chest imaging assesses pleural disease; ultrasound or CT can identify effusions. Analysis of pleural, pericardial, or peritoneal fluid includes cell counts, chemistry, cultures, and cytology; serology aids in identifying underlying disease.

Treatment targets the underlying cause and inflammation. NSAIDs are first-line for mild serositis; colchicine may be used for pericarditis. Corticosteroids or other immunosuppressants are reserved for autoimmune disease or refractory cases. Large effusions may require drainage. Prognosis depends on the cause and response to therapy.