Massive hydrothorax complicating occult cirrhosis

Area of Science:

• Hepatology
• Pulmonology
• Internal Medicine

Background:

• Cirrhosis is a common cause of ascites and pleural effusion.
• Massive pleural effusion typically suggests advanced liver disease.

Observation:

• A patient presented with massive pleural effusion but no ascites.
• Diagnostic workup revealed cirrhosis as the underlying cause.

Findings:

• Absence of ascites does not exclude cirrhosis in patients with massive pleural effusion.
• Hemochromatosis was identified as the cause of cirrhosis.

Implications:

• Early identification of hemochromatosis-induced cirrhosis can guide treatment with phlebotomy.
• Phlebotomy can alleviate iron overload, potentially improving cirrhosis prognosis.
• Screening relatives for hemochromatosis can enable early intervention and disease prevention.