Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2015 Dec;94(49):e2114.
doi: 10.1097/MD.0000000000002114.

Pleural Effusion in Meigs' Syndrome-Transudate or Exudate?: Systematic Review of the Literature

Affiliations
Free PMC article
Review

Pleural Effusion in Meigs' Syndrome-Transudate or Exudate?: Systematic Review of the Literature

Rafal Krenke et al. Medicine (Baltimore). .
Free PMC article

Abstract

Although Meigs' syndrome is regarded as a well-defined entity, contradictory data on pleural fluid characteristics have been presented, with some papers classifying it as a transudate, whereas others stating that it is an exudate.The aims of the study were: (1) to evaluate pleural fluid characteristics in patients with Meigs' syndrome and (2) to analyze the prevalence of transudative and exudative pleural effusion in relation to the applied definition of the syndrome.We performed a search through medical databases (MEDLINE, EMBASE, SCOPUS, and GOOGLE SCHOLAR) to identify papers on Meigs' syndrome published between 1940 and 2013. Two authors independently reviewed each paper searching for prespecified data: (1) signs and symptoms, (2) tumor characteristics, (3) clinical and laboratory data on ascites, (4) clinical, radiological, and laboratory data on pleural fluid, (5) clinical course after tumor removal. All case reports were reclassified according to a new unequivocal classification of Meigs' syndrome-related entities.A total of 653 papers were initially identified, and 454 articles reporting 541 patients were included in the final analysis. After reclassification according to our case definitions, there were 196, 113, and 108 patients defined as classic Meigs' syndrome, nonclassic Meigs' syndrome, and pseudo-Meigs' syndrome, respectively. Significantly more patients presented with right-sided than left-sided and bilateral pleural effusions (P < 0.001). Median volume of withdrawn pleural fluid was 2950 (1500-6000) mL. The classification of pleural effusion with the use of Light's criteria was possible in only 7 patients. In 6 of these patients pleural effusion met the criteria for an exudate. When the protein concentration > 3.0 g/dL was applied as a criterion of pleural exudate, 88.8% (80/90) of effusions were classified as exudates. Increasing the cut-off level to 3.5 g/dL resulted in only a modest decrease in the percentage of exudative effusions (81%, 73/90).Surprisingly few reports on Meigs' syndrome present data reliably defining the character of pleural effusion. The available data indicate, however, that the majority of pleural effusions in patients with this entity are exudates. This finding may be a prerequisite for the verification of some earlier presented concepts.

Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Flowchart presenting the selection process of papers subjected for analysis.

Similar articles

See all similar articles

Cited by 2 articles

References

    1. Yin H, Li XH, Xu HM, et al. Pseudo-Meigs’ syndrome secondary to bilateral ovarian endometrioid carcinomas. Int J Gynaecol Obstet 1999; 66:293–295. - PubMed
    1. Handler CE, Fray RE, Snashall PD. Atypical Meigs’ syndrome. Thorax 1982; 37:396–397. - PMC - PubMed
    1. Hooper C, Lee YC, Maskell N. BTS Pleural Guideline Group. Investigation of a unilateral pleural effusion in adults: British Thoracic Society Pleural Disease Guideline 2010. Thorax 2010; 65 suppl 2:ii4–17. - PubMed
    1. McGrath EE, Z. Blades J, Needham PB, et al. A systematic approach to the investigation and diagnosis of a unilateral pleural effusion. Int J Clin Pract 2009; 63:1653–1659. - PubMed
    1. Light RW. Pleural Diseases. 5th ed.2007; Philadelphia, PA: Wolters-Kluwer/Lippincott Williams & Wilkins, pp. 109–119 and 272–277.
Feedback