Case-based discussion from North Tyneside General Hospital: somatostatin analogues in yellow nail syndrome associated with recurrent pleural effusions

摘要: Kristian Brooks (KB): A 77-year-old man presented to accident and emergency with a 1-month history of progressive breathlessness reduced exercise tolerance. He had no chest pain, cough or wheeze, but bilateral leg swelling 4 kg weight loss. long-standing nail dystrophy and, following presentation recurrent lower respiratory tract infections several years previously, bronchiectasis been confirmed on high-resolution CT. was lifelong non-smoker, significant occupational asbestos exposure. There relevant family history. Chest radiograph showed large pleural effusions. Blood tests, including markers infection inflammation, were unremarkable. An ultrasound-guided tap lymphocytic exudate. Stephen C Bourke (SCB): The combination dystrophy, effusions, lymphoedema is consistent yellow syndrome (YNS), coexistent malignancy other pathology should be excluded, particularly in view the loss Pleural fluid sent for cholesterol triglycerides, cytology culture, mycobacterium TB. Thoracic CT echocardiography performed. Overall, most common causes effusions are In case series 41 patients YNS, around half which predominantly lymphocyte-rich more often than unilateral.1 Chylothorax may also occur classically appearing milky white due high levels blood stained. KB: No malignant cells seen fluid, TB stain culture negative. segmental consolidation left lobe plaques, pulmonary masses lymphadenopathy. Echocardiography normal biventricular function evidence pericardial effusion. Previous medical …