Question

All of the following show low glucose in pleural fluid, EXCEPT:

• A. Empyema
• B. Malignant pleural effusion
• C. Rheumatoid arthritis
• D. Dressler's syndrome

Hint:

Three of these chew up pleural glucose through infection, tumour, or rheumatoid inflammation; one is just an immune serositis.

Answer 1

The Correct Option is D

Memorise the short list of low glucose pleural effusions and the exception names itself. The causes that drop pleural fluid glucose below roughly 60 mg/dL are empyema (pus, swarming bacteria consuming sugar), rheumatoid pleuritis (famous for the lowest glucose of all, sometimes near zero), tuberculosis, malignancy (metabolically hungry tumour cells), and lupus pleuritis. The common thread is high cellular glucose consumption plus a pleural membrane too inflamed to shuttle glucose in. Now test each option: empyema, malignant effusion, and rheumatoid arthritis are all on that classic list, so they cannot be the answer. Dressler's syndrome is a post infarction autoimmune pericarditis and serositis, presenting with low grade fever, pleuritic pain, raised ESR, and pericardial or pleural effusion, but its effusion does not run a low glucose. So the odd one out is Dressler's syndrome.