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Pleural effusion transudate

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https://www.readbyqxmd.com/read/29778619/-a-very-unusual-pleural-presentation
#1
F Vergne, R Le Mao, L Simonin, R Descourt, F Couturaud, A Barnier, C Tromeur
Urinothorax refers to the presence of urine in the pleural space. Urinothorax is an infrequent and underdiagnosed pathology, with few cases reported, and these often suspected only with hindsight. It is usually a transudative pleural effusion. We report a case of urinothorax presenting as a purulent pleural effusion. Management of the urinothorax required antibiotics and surgical unblocking of the urinary tract. Currently, no test is available to confirm the diagnosis. The ratio of serum creatinine/pleural creatinine could suggest the presence of urinothorax but this parameter needs to be validated by complementary studies...
May 16, 2018: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/29724179/urinothorax-after-ultrasonography-guided-renal-biopsy-a-case-report
#2
Tae Won Lee, Ha Nee Jang, Hyun Seop Cho, See Min Choi, Bong-Hoi Choi, Eunjin Bae, Se-Ho Chang, Dong Jun Park
BACKGROUND: Urinothorax is defined as the presence of urine in the pleural space and is a rather rare cause of transudate pleural effusion. The potential etiologies are urinary tract obstruction and trauma. Diagnosis requires a high index of clinical suspicion and the condition is completely reversible following relief of underlying disease. CASE PRESENTATION: We report a 27-year-old man who developed urinothorax after renal biopsy. Urine leakage was confirmed with 99m Tc DTPA (diethylenetriaminepentacetate) and single-photon emission computed tomography scans and retrograde pyelography...
May 3, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29719749/a-case-of-transudative-chylothorax-a-diagnostic-dilemma
#3
Kartikeya Rajdev, Akshay Avula, Dikshya Sharma, Wissam Mansour, Shivika Agarwal, Abdul Hasan Siddiqui, Michel Chalhoub
Chylothorax is a type of pleural effusion characterized by the presence of chyle in the pleural space with triglyceride levels >110 mg/dL or evidence of chylomicrons in pleural fluid. Chylous effusion is typically exudative in nature with lymphocytic predominance. Transudative chylothorax is a rare finding which has been associated with only a limited range of clinical settings. We report a case of idiopathic transudative chylothorax for which the etiological cause could not be identified despite extensive workup and it resolved spontaneously after thoracentesis...
February 28, 2018: Curēus
https://www.readbyqxmd.com/read/29701188/-clinical-value-of-surfactant-protein-a-in-exudate-pleural-effusion
#4
Jing Guan, Jianmin Li, Yang Wang, Zhiguang Liu, Xiaoping Long, Chanyuan Pan
To evaluate the clinical value of surfactant protein-A (SP-A) in exudate pleural effusion (EPE).
 Methods: This clinical study was prospective, observational and cross-sectional. Two hundred and fifteen patients with pleural effusion were divided into the transudate pleural effusions (TPE) group and the EPE group. TPE patients served as the control group. The concentrations of pleural effusions SP-A (SP-Apl) and serum SP-A (SP-Ase) were measured by ELISA, and receiver operator characteristic (ROC) curve and multivarate Cox analysis of SP-A was analysed for its clinical value...
March 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29687517/hounsfield-units-are-a-useful-predictor-of-pleural-effusion-cytological-type-in-dogs-but-not-in-cats
#5
Sarah J Woods, Mathieu Spriet, Noa Safra, Derek D Cissell, Dori L Borjesson
All categories of pleural effusion subjectively display as soft tissue opacity on computed tomography (CT). Quantitative measurement using Hounsfield units (HU) has the potential to bring additional information regarding the nature of the fluid in a noninvasive way. The purposes of this retrospective cross-sectional analytical study were to compare Hounsfield units of different pleural effusion categories in dogs and cats, assess association between specific cytologic parameters and Hounsfield units, and evaluate the effect of dependent vs...
April 23, 2018: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/29675064/resolution-of-refractory-hepatic-hydrothorax-in-patients-with-hepatitis-c-virus-cirrhosis-after-treatment-with-direct-acting-antiviral-agents
#6
Maged H Hussein, Musthafa Chalikandy Peedikayil, Zamir Ahmed Zamir, Abdulrahman Alfadda
Hepatic hydrothorax (HH) is a transudative pleural effusion that complicates advanced liver cirrhosis. Cases refractory to medical treatment in the form of salt restriction and diuretics are labeled refractory hepatic hydrothorax (RHH) and may require transjugular intrahepatic portosystemic shunts (TIPSS) or even liver transplantation. Renal impairment is common in advanced liver disease, worsens its prognosis, and makes the management of HH more challenging. Successful antiviral therapy reduces some of the complications of cirrhosis secondary to hepatitis C virus (HCV) infection...
April 2018: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/29572611/usefulness-of-a-pleuroperitoneal-shunt-for-treatment-of-refractory-pleural-effusion-in-a-patient-receiving-maintenance-hemodialysis
#7
Masato Habuka, Toru Ito, Yuta Yoshizawa, Koji Matsuo, Shuichi Murakami, Daisuke Kondo, Hiroshi Kanazawa, Ichiei Narita
Refractory pleural effusion can be a life-threatening complication in patients receiving maintenance hemodialysis. We report successful treatment of refractory pleural effusion using a Denver® pleuroperitoneal shunt in one such patient. A 54-year-old Japanese man, who had previously undergone left nephrectomy, was admitted urgently to our department because of a high C-reactive protein (CRP) level, right pleural effusion, and right renal abscess. Because antibiotics proved ineffective and his general state was deteriorating, he underwent emergency insertion of a thoracic drainage tube and nephrectomy, and hemodialysis was started...
March 23, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29531478/recurrent-pleural-effusion-as-a-result-of-bilateral-renal-artery-stenosis-does-renal-revascularization-help
#8
Ashraf Abugroun, Marion Gonzalez, Daniel Vilchez
Renal artery stenosis (RAS) is the leading cause of secondary hypertension. Renal artery stenosis can result in various cardiopulmonary complications mostly through activation of neurohormonal pathways that result in fluid overload and systemic hypertension. We herein describe a 72-year-old man with recurrent rapidly accumulating transudative pleural effusion in a patient with severe bilateral RAS. Patient pleural effusion resolved following stent placement with revascularization of the left renal artery despite absence of improvement of renal function...
2018: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/29503942/drainage-and-analysis-of-suprachoroidal-fluid-in-a-patient-with-acute-systemic-lupus-erythematous
#9
James A Stefater, Dean Eliott, Leo A Kim
Purpose: To describe a case of a patient with acute systemic lupus erythematous (SLE) causing choroidal effusions and to report a novel technique for evaluation of the choroidal fluid which sheds light on effusion pathogenesis. Observations: A 37 year-old woman was referred for decreased vision, eye pain and shortness of breath. The patient had bilateral angle closure glaucoma from choroidal effusions and bilateral pleural effusions. Work-up revealed new onset acute SLE...
April 2017: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29411725/vascular-endothelial-growth-factor-in-pleural-effusions-and-correlation-with-radiologic-and-biochemical-parameters
#10
N Bayram, Y Karakan, M Uyar, B Ozyurt, A Filiz
INTRODUCTION: Pleural effusion is a common clinical problem with management difficulties. The aim of this study is to evaluate vascular endothelial growth factor (VEGF) in differential diagnosis of pleural effusions and the presence of correlation between radiological features and biochemical properties. MATERIALS AND METHODS: The study included patients with pleural effusion. VEGF levels in the pleural fluid were measured by enzyme-linked immunosorbent assay. RESULTS: A total of 97 patients who had exudative pleural effusion related to lung cancer (n = 17), nonpulmonary malignancies (n = 25), mesothelioma (n = 9), pneumonia (n = 14), tuberculosis (n = 8), miscellaneous causes (n = 6), and transudative effusion (n = 18) were included...
January 2018: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29346252/sarcoidosis-with-pleural-effusion-as-the-presenting-symptom
#11
Estefania Rivera, Yaron Gesthalter, Paul Vardelaan, Alex Chee, Adnan Majid
A 65-year-old woman, never smoker, with medical history of hypertension, nonischemic cardiomyopathy, and moderate pulmonary hypertension presented with symptomatic bilateral pleural effusions. Thoracentesis revealed a lymphocyte predominant transudate and was negative for malignancy, microbiologic cultures were negative for an infectious cause. Chest tomography showed mediastinal and bilateral hilar lymphadenopathy, lymph node biopsy with endobronchial ultrasound-guided transbronchial needle aspiration showed non-necrotizing granulomas compatible with sarcoidosis...
April 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29311408/hepatic-hydrothorax
#12
Yong Lv, Guohong Han, Daiming Fan
Hepatic hydrothorax (HH) is a pleural effusion that develops in a patient with cirrhosis and portal hypertension in the absence of cardiopulmonary disease. Although the development of HH remains incompletely understood, the most acceptable explanation is that the pleural effusion is a result of a direct passage of ascitic fluid into the pleural cavity through a defect in the diaphragm due to the raised abdominal pressure and the negative pressure within the pleural space. Patients with HH can be asymptomatic or present with pulmonary symptoms such as shortness of breath, cough, hypoxemia, or respiratory failure associated with large pleural effusions...
January 2018: Annals of Hepatology
https://www.readbyqxmd.com/read/29297451/cxcr3-ligands-in-pleural-fluid-as-markers-for-the-diagnosis-of-tuberculous-pleural-effusion
#13
W Chung, Y Jung, K Lee, J Park, S Sheen, K Park
SETTING: A tertiary care academic medical centre. OBJECTIVE: To evaluate the clinical usefulness of C-X-C motif chemokine receptor 3 (CXCR3) ligands in tuberculous pleural effusion (TPE). DESIGN: We recruited 336 patients with pleural effusion due to various causes. Concentrations of interferon-gamma (IFN-γ) and the CXCR3 ligands CXCL9 and CXCL11 were determined using enzyme immunoassays; adenosine deaminase (ADA) activity was measured in pleural fluid and serum...
December 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/29231161/pleural-and-pericardial-effusion-in-a-long-term-pd-patient-a-defying-diagnosis
#14
Iolanda Godinho, Joana M Dias, Natacha Rodrigues, Hugo Silva, Sofia Jorge, Cristina P Abreu, José A Lopes
Peritoneopleural shunt is an uncommon complication of peritoneal dialysis (PD) usually presenting early as a right pleural transudate. Peritoneopericardial shunt is an even rarer entity in PD, almost never occurring spontaneously. We present the case of a 37-year-old woman on PD for 24 months exhibiting a left pleural and pericardial effusion following pneumonia. Pleural fluid was initially compatible with an exudate with a high glucose concentration and later with a transudate. In order to clarify the suspicion of an ongoing shunt an abdominal scintigraphy was performed confirming the diagnosis of a peritoneopleuropericardial communication...
February 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29221292/a-comparative-study-of-conventional-cytology-and-cell-block-method-in-the-diagnosis-of-pleural-effusion
#15
Theerada Assawasaksakul, Viboon Boonsarngsuk, Pimpin Incharoen
Background: In a patient with pleural effusion, cytological study (CS) is one of the most useful investigations, especially when malignancy is suspected. Instead of applying only CS, the pleural fluid can be further processed using the cell block (CB) technique, which may augment the diagnostic utility. The aim of this study was to compare the diagnostic yields of CS, CB, and the combination of both, regardless of the etiology of pleural effusion. Methods: A cross-sectional study was conducted on patients with pleural effusions who underwent thoracentesis from June 2015 to May 2016...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29063807/unilateral-pleural-effusion-as-the-sole-clinical-presentation-of-severe-ovarian-hyperstimulation-syndrome-a-systematic-review
#16
Mohamad Irani, Alex Robles, Vinay Gunnala, Pak Chung, Zev Rosenwaks
The pathophysiology of isolated pleural effusion in ovarian hyperstimulation syndrome (OHSS) is not well defined. The objective of the current review is to delineate the pathophysiology, risk factors, preventive measures, and therapeutic options of isolated pleural effusion in severe OHSS. Major databases were searched until June 2016. Studies evaluating women who presented with pleural effusion as the sole extra-ovarian manifestation of severe OHSS were included. Data were extracted from 24 articles encompassing 30 reported cases...
February 2018: Gynecological Endocrinology
https://www.readbyqxmd.com/read/29062682/transudative-chylothorax-in-a-patient-with-lymphangioleiomyomatosis
#17
Adrian Pedro Noriega Aldave, John W Leslie
Transudative chylothorax is a rare type of pleural effusion. It has been described to be present in the setting of liver cirrhosis, heart failure, amyloidosis, nephrotic syndrome, superior vena cava thrombosis, sclerosing mesenteritis and heart failure. We present the case of an 86-year-old woman with a right-side transudative chylothorax associated with heart failure and lymphangioleiomyomatosis.
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29047238/identification-of-10-candidate-biomarkers-distinguishing-tuberculous-and-malignant-pleural-fluid-by-proteomic-methods
#18
Chang Youl Lee, Ji Young Hong, Myung Goo Lee, In Bum Suh
PURPOSE: Pleural effusion, an accumulation of fluid in the pleural space, usually occurs in patients when the rate of fluid formation exceeds the rate of fluid removal. The differential diagnosis of tuberculous pleurisy and malignant pleural effusion is a difficult task in high tuberculous prevalence areas. The aim of the present study was to identify novel biomarkers for the diagnosis of pleural fluid using proteomics technology. MATERIALS AND METHODS: We used samples from five patients with transudative pleural effusions for internal standard, five patients with tuberculous pleurisy, and the same numbers of patients having malignant effusions were enrolled in the study...
November 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28965174/lactate-determination-in-pleural-and-abdominal-effusions-a-quick-diagnostic-marker-of-exudate-a-pilot-study
#19
Giovanni Porta, Fabio G Numis, Valerio Rosato, Antonio Pagano, Mario Masarone, Giorgio Bosso, Claudia Serra, Luca Rinaldi, Maria C Fascione, Annalisa Amelia, Fiorella Paladino, Fernando Schiraldi
Pleural or abdominal effusions are frequent findings in ICU and Internal Medicine patients. Diagnostic gold standard to distinguish between transudate and exudate is represented by "Light's Criteria," but, unfortunately, the chemical-physical examination for their calculation is not a rapid test. Pursuing an acid-base assessment of the fluid by a blood-gas analyzer, an increase of lactate beyond the normal serum range is reported in the exudative effusions. The advantages of this test are that it is a very fast bed-side test, executable directly by the physician...
September 30, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28920536/pleural-lymphocyte-rich-transudates-in-cats
#20
Monica Probo, Valentina Valenti, Luigi Venco, Saverio Paltrinieri, Emme Lavergne, Catherine Trumel, Walter Bertazzolo
Objectives Non-chylous lymphorrhagic pleural effusions are transudative effusions with a predominance of lymphocytes; however, they do not contain chylomicrons and therefore do not have the classical milky aspect of true chylous effusion. This type of effusion has been anecdotally associated with cardiac diseases in cats, but studies are lacking. The aim of this study was to investigate the association between this type of effusion and the primary disease. Methods In this study, feline non-chylous lymphorrhagic pleural effusions were retrospectively selected from the database of the authors' institutions over a 3 year period...
September 1, 2017: Journal of Feline Medicine and Surgery
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