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I am sorry that this is happening to you and that you are without answers. I know how frustrating this is! From what I remember, pleural thickening with effusion has many causes from congestive heart failure, liver/kidney disease, infections (TB and bacterial), mesothelioma, and collagen vascular diseases (lupus, RA)...You said that your doc did alot of blood tests, did he or she test for RA, Lupus etc..? If not, then that would be something to look into....I wish I had more thoughts but I am at a block. I hope you find answers soon..Sunny