Immunological abnormalities in shrinking pleuritis with atelectasis.

The immunological status of 14 patients with shrinking pleuritis with atelectasis (SPA) was assessed by skin testing for delayed hypersensitivity reactions and in vitro tests of peripheral blood lymphocyte reactivity. The results were compared with those of 3 control groups, one consisting of healthy men, one of workers exposed to asbestos and one of workers exposed to quartz dust. Only 2 of 14 SPA patients showed a positive skin reaction to 2.4-dinitrochlorobenzene (DNCB). The cutaneous reactions to candida and varidase were significantly increased in the SPA group compared with the other groups (p less than 0.05). The response of the blood lymphocytes to stimulation with phytohaemagglutinin was significantly decreased in the SPA group (p less than 0.01), as was unstimulated lymphocyte proliferation (p less than 0.05). The results suggest a primary or secondary immune abnormality in the SPA group. The exact nature of the defect requires further elucidation.