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Pleural effusion and hydronephrosis in a newborn.
1Family Health Services, Kansas City, KS 66103.
The Journal of the American Board of Family Practice
|January 1, 1989
Summary
Obstructive uropathy in newborns can cause rare pleural effusions. Prompt urinary drainage relieved the effusion, highlighting hydronephrosis as a diagnostic consideration for unexplained neonatal pleural effusions.
Area of Science:
- Pediatric Nephrology
- Neonatal Medicine
- Pulmonology
Background:
- The association between obstructive uropathy and fluid accumulation (ascites, pleural effusion) is documented.
- Neonatal pleural effusion secondary to obstructive uropathy is a rare clinical presentation.
Observation:
- A male newborn presented with massive left-sided pleural effusion.
- The effusion was linked to same-sided hydronephrosis caused by obstructing posterior urethral valves.
Findings:
- Pleural effusion resolved rapidly following the establishment of adequate urinary drainage.
- A direct inverse relationship was observed between pleural fluid drainage volume and urinary output via catheter.
- Cystoscopic fulguration of posterior urethral valves led to sustained infant well-being.
Implications:
- Hydronephrosis should be considered in the differential diagnosis of unexplained neonatal pleural effusions.
- This case underscores the importance of evaluating the urinary system in neonates with pleural effusions.
- The findings suggest a potential mechanism for fluid shifts in obstructive uropathy.