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Recurrent symptomatic pleural effusion from a syringopleural shunt.
Crystal T Ajja1, Tiffany F Chang1, Eric Ayers1
1Department of Internal Medicine-Pediatrics, Wayne State University/Detroit Medical Center, Detroit, Michigan.
Proceedings (Baylor University. Medical Center)
|May 6, 2021
Summary
A rare complication of syringopleural shunts is recurrent pleural effusion, indicated by beta-2 transferrin in pleural fluid. Management may involve shunt revision or conversion to other shunt types.
Area of Science:
- Neurosurgery
- Thoracic Medicine
- Medical Device Complications
Background:
- Syringopleural shunts are used to manage syringomyelia, diverting cerebrospinal fluid to the pleural space.
- Recurrent pleural effusion is a potential, though uncommon, complication associated with these shunts.
Observation:
- A patient presented with dyspnea and cough due to a recurrent large pleural effusion.
- Computed tomography revealed the syringopleural shunt catheter adjacent to the effusion.
- Beta-2 transferrin, a marker for cerebrospinal fluid, was detected in the pleural fluid.
Findings:
- The presence of beta-2 transferrin in the pleural fluid confirmed cerebrospinal fluid leakage.
- The findings suggest the recurrent symptomatic pleural effusion was a complication of the syringopleural shunt.
Implications:
- Physicians must be aware of this potential long-term complication of syringopleural shunts.
- Management strategies include revising the shunt with a programmable device or converting to a syringoperitoneal or syringoarachnoid shunt.
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