Pleural Diseases and Endocrine Disorders: Modern Approaches to the Treatment of Comorbid Conditions

The article discusses the relationship between diseases of the pleura (pleural effusion, pleurisy, empyema) and endocrine disorders, in particular hypothyroidism, as a potential modifying factor in the course of pleural pathology. An analysis of modern literature sources on the pathogenetic mechanisms of pleural effusion formation in thyroid dysfunction, clinical features, diagnostic approaches and effectiveness of levothyroxine replacement therapy has been carried out. It has been found that some patients with hypothyroidism develop pleural effusions, which regress after reaching euthyroid. The paper describes epidemiological, diagnostic, clinical, pharmacological and organizational gaps in the study of this comorbid condition. The authors proposed an algorithm for the initial diagnosis of pleural effusions and routing of patients, taking into account the determination of thyroid status. ABC/VED analysis of drugs used in the pharmacotherapy of hypothyroid-associated diseases of the pleura was performed. Levothyroxine has been shown to be a key etiotropic agent, and timely hormonal correction reduces the need for invasive procedures and improves clinical outcomes. The importance of a multidisciplinary approach to diagnosis and treatment, which combines pulmonological, endocrinological and clinical-pharmacological aspects, is emphasized.