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Primary nephrotic syndrome complicated by chylothorax: a case report
Yongwei Xu1, Jinpeng Shi2, Shuchang Xu1
1Department of Gastroenterology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
Annals of Palliative Medicine
|November 15, 2021
Summary
Nephrotic syndrome can cause chylothorax, a rare condition where lymphatic fluid leaks into the chest. This case report details a patient with membranous nephropathy and severe chylothorax, highlighting potential mechanisms and treatment strategies.
Area of Science:
- Nephrology
- Pulmonology
- Internal Medicine
Background:
- Chylothorax is a rare but serious condition, often caused by trauma.
- The mechanism linking nephrotic syndrome to chylothorax remains unclear.
- Primary nephrotic syndrome, particularly with membranous nephropathy, is an uncommon cause.
Observation:
- A 66-year-old man with primary nephrotic syndrome and membranous nephropathy presented with severe chylothorax.
- The patient experienced significant pleural effusion of chylous fluid.
- Management involved chest tube drainage, enoxaparin, anti-inflammatory agents, and diuretics.
Findings:
- Treatment led to decreased pleural effusion and clearing of chylous fluid.
- Hypoproteinemia is hypothesized to increase mucous membrane and lymphatic vessel permeability.
- Severe tissue edema and lymphatic wall pressure may also contribute to lymphatic leakage.
Implications:
- This case enhances understanding of chylothorax as a complication of nephrotic syndrome.
- It provides insights into the potential pathophysiology involving hypoproteinemia and edema.
- The report offers clinical reference for managing similar rare cases in nephrotic syndrome patients.
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