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1例罕见的膜性肾病合并乳糜胸病例

A Rare Case of Membranous Nephropathy Complicated by Chylothorax.

作者信息

Farouji Abdelhadi, Kloub Mohammad N, Haddad Ahmad W, Ahmad Amaar S, Chow Priscilla, Miller Richard

机构信息

Department of Internal Medicine, Saint Michael's Medical Center, New York Medical College, Newark, USA.

Department of Pulmonary and Critical Care Medicine, Saint Michael's Medical Center, New York Medical College, Newark, USA.

出版信息

Eur J Case Rep Intern Med. 2024 Jun 11;11(7):004631. doi: 10.12890/2024_004631. eCollection 2024.

Abstract

BACKGROUND

Chylothorax can be classified into traumatic and nontraumatic based on the etiology. Nephrotic syndrome is a very rare cause of nontraumatic chylothorax in adults.

CASE PRESENTATION

A 66-year-old woman with membranous nephropathy who was non-compliant with her management, presented with dyspnea, and was found to have a large right sided chylothorax. Her chylothorax was secondary to membranous nephropathy after excluding other causes, which has been rarely reported in literature.

CONCLUSION

This case highlights the possibility of nephrotic syndrome causing chylothorax, especially in patients with undiagnosed nephrotic syndrome or patients non-compliant with their management. When evaluating a patient with chylothorax, providers should consider nephrotic syndrome in the differential diagnosis.

LEARNING POINTS

Chylothorax can be secondary to nephrotic syndrome which has been rarely reported in literature.Providers should be aware of nephrotic syndrome as a cause of chylothorax especially in patients with undiagnosed nephrotic syndrome or non-compliance with their management.Treatment of underlying cause is usually sufficient for spontaneous resolution of chylothorax with or without pleural fluid evacuation.

摘要

背景

乳糜胸可根据病因分为创伤性和非创伤性。肾病综合征是成人非创伤性乳糜胸非常罕见的病因。

病例介绍

一名66岁的膜性肾病女性患者,未遵医嘱治疗,出现呼吸困难,检查发现右侧大量乳糜胸。排除其他病因后,其乳糜胸继发于膜性肾病,这在文献中鲜有报道。

结论

该病例凸显了肾病综合征导致乳糜胸的可能性,尤其是在未确诊的肾病综合征患者或未遵医嘱治疗的患者中。在评估乳糜胸患者时,医生应在鉴别诊断中考虑肾病综合征。

学习要点

乳糜胸可继发于肾病综合征,这在文献中鲜有报道。医生应意识到肾病综合征是乳糜胸的一个病因,尤其是在未确诊的肾病综合征患者或未遵医嘱治疗的患者中。治疗潜在病因通常足以使乳糜胸自行消退,无论是否进行胸腔积液引流。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dd9/11229468/5a72e8c733a6/4631_Fig1.jpg

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