Pseudochylous Pleural Effusion in a case of Rheumatoid Arthiritis
Keywords:
Pseudochylous, Rheumatoid Arthritis, Cholesterol, Pleural Effusions
Abstract
Chyliform (pseudochylous) pleural effusions accumulate gradually due to the breakdown of cellular lipids in long standing pleural effusions, such as Rheumatoid Arthritis (RA) and Tuberculosis. These are also known as cholesterol effusions due to high cholesterol levels in pleural fluid and presence of cholesterol crystals on wet mount. We present the case report of a 60 year old lady, who came to the medicine out patient department with breathlessness and generalized body ache. Radiological investigation revealed a left sided pleural effusion with atelectasis. Based on the characteristic biochemical and cytological findings in the pleural fluid, a diagnosis of pseudochylous effusion was made. Test for rheumatoid factor was done subsequently due to the presence of joint pains, and it was positive.References
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2) Hillerdal G. Chyliform pleural effusion. Chest 1985; 88:426-8.
3) Hamm H, Pfalzer B, Fabel H. Lipoprotein analysis in a chyliform pleural effusion: implications for pathogenesis and diagnosis. Respiration 1991; 58:294-300.
4) Wrightson JM, Stanton AE, Maskell NA, Davies RJ, Lee YC. Pseudochylothorax without pleural thickening: time to reconsider pathogenesis? Chest 2009;136:1144-7.
5) Hillerdal G. Chylothorax and pseudochylothorax. Eur Respir J 1997; 10:1157-62.
6) Hamn H, Pfalzer B, Fabel H. Lipoprotein analysis in a chyle form pleural effusion: implications for pathogenesis and diagnosis. Respiration 1991;58:294-300.
7) De Beer HG, Mol MJ, Janssen JP. Chylothorax. Neth J Med 2000; 56:25–31.
8) Staats BA, et al. The lipoprotein profile of chylous and nonchylous pleural effusions. Mayo Clin Proc 1980; 55:700–4.
9) Highland KB, Heffner JE. Pleural effusion in interstitial lung disease. Curr Opin Pulm Med 2004;10.
10) Genzen JR, Motin A. Cholesterol crystals in pleural fluid. American Journal of Respiratory and Critical care medicine 2012; 185:586.
11) Huggins JT. Chylothorax and cholesterol pleural effusion. Semin Respir Crit Care Med 2010; 31:743-50.
Published
2016-12-11
Section
Case Report
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