Pleural amyloidosis presenting as recurrent bilateral pleural effusions

Amyloidosis is a disease of insoluble protein deposition. It can affect many organ systems but less commonly found in the lung. Pleural effusions secondary to amyloidosis are rare and sparsely reported in the literature. The incidence ranges from 9 to 14 per million person-years. We present a case report of a 77-year-old female with respiratory distress and recurrent bilateral pleural effusions and known intra-abdominal amyloidosis. Initially, we attempted conservative non-operative management using tube thoracostomy drainage with lytic medications. But ultimately, she required decortication with the hope of promoting symphysis of her lung and chest wall to prevent recurrent effusions. Further investigation is warranted in this disease process, as the exact mechanism remains elusive. The same holds true regarding a standardized treatment approach due to the rarity of the disease.