This is a long shot but just in case it might help: I had frequent pleural effusions, almost monthly thoracenteses, and then was diagnosed with Lupus. I was treated with mycophenolate (the only Lupus drug I could tolerate) and did not have another accumulation for several years. In the interim I moved from UCLA in L.A. to Charlotte NC. My rheumatologist here took me off the mycophenolate and tried alternatives that I couldn't stomach. I have been without Lupus treatment since and the fluid has definitely returned to my lungs. I was hospitalized for 5 days for cellulitis and they planned to do a thoracentesis while I was there but after 5 days of Lasix they felt there wasn't enough fluid remaining to safely perform the procedure. I can't see the new rheumatologist until the end of October but I'm hoping resuming mycophenolate will help. I did have several years with no evidence of fluid accumlation while I was taking it before. My case is complicated by Emphysema and heart disease but am tossing you Lupus as a possible cause that the Docs haven't yet considered. I'm certainly hoping that getting back on the mycophenolate will help me! Maybe it could help you too? Margaret