Pleural Disorders Causes and Risk Factors

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Pleural disorders may be caused by inflammation, injury, or an imbalance of fluids in the pleural space. Your age and family history may increase your risk. You may also be at higher risk if you take certain medicines, smoke tobacco or marijuana, or have other medical conditions. You may be able to help prevent pleural disorders by quitting smoking or not starting if you don’t smoke.

Pleural disorders may be caused by one of the following.

• Inflammation in the pleura: The inflammation may happen because of an infection, tumor, or another medical condition. The inflammation affects the two thin layers of the pleura. This can cause the surface of the layers to become rough and the fluid in between the layers to become sticky. When this happens, the two layers may rub together every time you breathe in instead of gliding past each other.
• Injury to the chest: Even an injury that does not break the skin but causes internal damage, can allow air, fluid, or blood to leak into the pleural space. This can cause a pneumothorax or pleural effusion.
• Procedure such as chest  biopsy , mechanical ventilation, or thoracentesis: This can cause blood or air to leak into the pleural space.
• Fluid imbalance: Pleural effusions develop when fluid enters the pleural space faster or at a higher amount than the body can reabsorb. This imbalance of fluids can be caused by heart, kidney, or liver failure, or other medical conditions.

Your risk for pleural disorders may be higher based on some factors you can control and some, like your age, that you can't control. 

• Age: Pleural disorders can happen at any age, but pneumothorax is most common in people 15 to 34 years old and people over age 55.
• Family history: If someone in your family had spontaneous pneumothorax, your risk of having this disease is higher.
• Lifestyle habits: Smoking tobacco or marijuana raise your risk of spontaneous pneumothorax.
• Medical history: The medicines you take may raise your risk, including blood thinners, cancer medicines, and nitrofurantoin, an antibiotic to treat urinary tract infections. Some health conditions may also raise the risk for pleural disorders, such as cancer, heart failure, autoimmune diseases, kidney disease, lung disease, and sickle cell disease.
• Sex: Men, especially those who are taller than average, are more likely than women to have a spontaneous pneumothorax, often without underlying lung disease.

Because your lifestyle habits and other medical conditions can raise your risk of pleural disorders, your doctor may talk to you about steps you can take to prevent them. 

• Treating conditions that increase the risk of pleural disorders
• Quitting smoking: Visit Smoking and Your Heart and the National Heart, Lung, and Blood Institute’s Your Guide to a Healthy Heart. For free help quitting smoking, you may call the National Cancer Institute’s Smoking Quitline at 1-877-44U-QUIT (1-877-448-7848).
• Quitting or avoiding illegal drugs, such as marijuana