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Pleural effusion transudate

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
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
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
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...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
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...
December 27, 2017: Annals of Hepatology
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
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
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
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...
October 24, 2017: Gynecological Endocrinology
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
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
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
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
Nina C Zitzer, Antoinette E Marsh, Mary Jo Burkhard, M Judith Radin, Maxey L Wellman, Maria Jugan, Valerie Parker
An 8-year-old, 6-kg, male neutered Domestic Shorthair cat was presented to The Ohio State University Veterinary Medical Center (OSU-VMC) for difficulty breathing. Physical examination and thoracic radiographs indicated pneumonia, a soft-tissue mass in the left caudal lung lobe, and diffuse pleural effusion. The effusion was classified as modified transudate. Rare extracellular elongated (~5-7 μm × 1-2 μm) zoites with a central round to oval-shaped purple to deep purple vesicular nucleus with coarsely stippled chromatin and light blue cytoplasm were seen on a peripheral blood smear...
September 2017: Veterinary Clinical Pathology
Chao He, Bo Wang, Danni Li, Huan Xu, Yongchun Shen
BACKGROUND: Parapneumonic pleural effusion (PPE) is a common complication of pneumonia. The accurate diagnosis of PPE remains a challenge. Recent studies suggest that procalcitonin (PCT) emerges as a potential biomarker for PPE. Our study aimed to determine the diagnostic value of PCT for PPE by a clinical study and summarize the overall diagnostic performance of PCT through a meta-analysis. METHODS: Demographic and clinical data of the patients with PPE and controls were collected in our clinical study...
August 2017: Medicine (Baltimore)
Adam Austin, Sidharth Navin Jogani, Paul Bradley Brasher, Rahul Gupta Argula, John Terrill Huggins, Amit Chopra
Urinothorax is an uncommon thoracic complication of genitourinary (GU) tract disease, which is most frequently caused by obstructive uropathy, but may also occur as a result of iatrogenic or traumatic GU injury. It is underrecognized because of a perceived notion as to the rarity of the diagnosis and the absence of established diagnostic criteria. Urinothorax is typically described as a paucicellular, transudative pleural effusion with a pleural fluid/serum creatinine ratio >1.0. It is the only transudate associated with pleural fluid acidosis (pH < 7...
July 2017: American Journal of the Medical Sciences
Ronan A Mullins, Marc A Barandun, Barbara Gallagher, Laura C Cuddy
CASE SUMMARY: A 6-month-old spayed female domestic shorthair cat presented for evaluation of suspected bite wounds over the right caudal thorax and left cranial flank. Thoracic radiographs identified a mild right-sided pneumothorax, a small volume of right-sided pleural effusion, with increased soft tissue opacity in the right cranial and middle lung lobes. Abdominal ultrasound identified a very small gall bladder and several small pockets of free peritoneal fluid. Cytological analysis of peritoneal fluid was consistent with a modified transudate...
January 2017: JFMS Open Reports
Lucía Ferreiro, José M Porcel, Luis Valdés
Various clinical trials have been published on the optimal clinical management of patients with pleural exudates, particularly those caused by malignant tumors, while little information is available on the diagnosis and treatment of pleural transudates. The etiology of pleural transudates is wide and heterogeneous, and they can be caused by rare diseases, sometimes constituting a diagnostic challenge. Analysis of the pleural fluid can be a useful procedure for establishing diagnosis. Treatment should target not only the underlying disease, but also management of the pleural effusion itself...
June 19, 2017: Archivos de Bronconeumología
Cheng Wang, Jingjin Peng, Yanling Kuang, Jiaqiang Zhang, Luming Dai
Pleural effusion is a common clinical manifestation with various causes. Current diagnostic and therapeutic methods have exhibited numerous limitations. By involving the analysis of dynamic changes in low molecular weight catabolites, metabolomics has been widely applied in various types of disease and have provided platforms to distinguish many novel biomarkers. However, to the best of our knowledge, there are few studies regarding the metabolic profiling for pleural effusion. In the current study, 58 pleural effusion samples were collected, among which 20 were malignant pleural effusions, 20 were tuberculous pleural effusions and 18 were transudative pleural effusions...
August 2017: Molecular Medicine Reports
Maura E Duffy, Andrew J Specht, Ahmira R Torres, May-Li Cuypers
CASE DESCRIPTION A 3-year-old spayed female Bengal cat was evaluated because of a history of bilateral pleural effusion and hydronephrosis of the right kidney. CLINICAL FINDINGS Cytologic analysis of a pleural fluid sample revealed characteristics of a pure transudate with a high percentage of lymphocytes. Results of fluid biochemical testing were not consistent with urine or chyle. Serum biochemical analysis and echocardiography yielded no evidence of hypoalbuminemia or high hydrostatic pressure secondary to cardiac disease...
July 1, 2017: Journal of the American Veterinary Medical Association
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