Refractory bilateral chylothorax and chylous ascites in a patient with systemic lupus erythematosus treated by pleuro-peritoneal and peritoneal-venous shunts along with cell-free and concentrated ascites re-infusion therapy
{"title":"Refractory bilateral chylothorax and chylous ascites in a patient with systemic lupus erythematosus treated by pleuro-peritoneal and peritoneal-venous shunts along with cell-free and concentrated ascites re-infusion therapy","authors":"Yuki Kuwahara , Hiroki Tashiro , Go Takeshita , Yoshiaki Egashira , Akihito Maruyama , Yuki Ikeda , Shinya Kimura , Naoko Sueoka-Aragane , Koichiro Takahashi","doi":"10.1016/j.resinv.2024.10.006","DOIUrl":null,"url":null,"abstract":"<div><div>A pleural effusion is a common pulmonary manifestation of systemic lupus erythematosus (SLE), and differential diagnosis is needed to perform targeted treatments. An SLE patient with refractory chylothorax is presented. Chylothorax rarely occurs in SLE patients and occasionally follows a refractory clinical course despite intensive treatment with immunosuppressive therapies, resulting in a poor prognosis with malnutrition caused by frequent thoracenteses. In such cases, pleuro-peritoneal and peritoneal-venous shunts along with cell-free and concentrated ascites re-infusion therapy might be effective to improve the dyspnea while maintaining nutrition.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1191-1194"},"PeriodicalIF":2.4000,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respiratory investigation","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2212534524001631","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
Abstract
A pleural effusion is a common pulmonary manifestation of systemic lupus erythematosus (SLE), and differential diagnosis is needed to perform targeted treatments. An SLE patient with refractory chylothorax is presented. Chylothorax rarely occurs in SLE patients and occasionally follows a refractory clinical course despite intensive treatment with immunosuppressive therapies, resulting in a poor prognosis with malnutrition caused by frequent thoracenteses. In such cases, pleuro-peritoneal and peritoneal-venous shunts along with cell-free and concentrated ascites re-infusion therapy might be effective to improve the dyspnea while maintaining nutrition.