Can talc pleurodesis cause eosinophilia (elevated eosinophil count)?

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Last updated: March 26, 2025View editorial policy

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From the Guidelines

Talc pleurodesis can cause eosinophilia, as evidenced by the body's inflammatory response to the introduction of talc into the pleural space. Talc pleurodesis is a procedure where talc is introduced into the pleural space to create inflammation and adhesion between the pleural layers, typically to prevent recurrent pleural effusions or pneumothorax. When talc is introduced, it triggers an inflammatory response that can include an increase in eosinophils in both the pleural fluid and peripheral blood, as seen in various studies on pleurodesis agents 1. This eosinophilic response is part of the body's reaction to the foreign substance and the inflammatory process. The eosinophilia is usually transient and resolves as the acute inflammatory phase subsides, typically within days to weeks after the procedure.

Key Considerations

  • Patients undergoing talc pleurodesis should be monitored for signs of systemic inflammatory response, including fever, chest pain, and respiratory distress.
  • Blood tests may show elevated white blood cell counts with increased eosinophils, which is considered a normal part of the healing process following pleurodesis.
  • Severe or persistent eosinophilia may require further evaluation to rule out other causes, as recommended by guidelines for managing malignant pleural effusions 1.
  • The decision to use talc poudrage or talc slurry for pleurodesis depends on several factors, including local expertise and patient-related factors, but the potential for eosinophilia should be considered in the management plan.

Clinical Implications

  • Clinicians should be aware of the potential for eosinophilia following talc pleurodesis and monitor patients accordingly.
  • The benefits of talc pleurodesis in preventing recurrent pleural effusions or pneumothorax should be weighed against the potential risks, including eosinophilia, as part of the overall management plan 1.

From the Research

Talc Pleurodesis and Eosinophilia

  • There are no direct references to eosinophilia (elevated eosinophil count) in the provided studies 2, 3, 4, 5, 6.
  • The studies discuss the safety and efficacy of talc pleurodesis in treating malignant pleural effusions, but do not mention eosinophilia as a potential complication or side effect.
  • The studies do report various complications and side effects, such as acute respiratory distress syndrome (ARDS) 4, 5, 6, chest pain, transient fever, and empyema 4, but eosinophilia is not mentioned.
  • As a result, there is no evidence from these studies to suggest that talc pleurodesis can cause eosinophilia.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Is thoracoscopic talc pleurodesis really safe?

Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace, 2004

Research

[Talc pleurodesis in malignant pleural effusions].

Pneumologie (Stuttgart, Germany), 2006

Research

Serious complications with talc slurry pleurodesis.

Respirology (Carlton, Vic.), 2001

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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