Thoracoscopy under Local Anesthesia was Useful for Diagnosing Yellow Nail Syndrome

An 80-year-old woman with rheumatoid arthritis and a past history of tuberculosis presented with exertional dyspnea and edema of both legs. Chest X-ray performed on admission showed bilateral pleural effusion. Thoracoscopy under local anesthesia was performed, and vasodilation and non-specific yello...

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Bibliographic Details
Published in:Internal Medicine 2016, Vol.55(8), pp.975-980
Main Authors: Ro, Shoki, Ishii, Satoru, Hayashi, Yukie, Kobayashi, Konomi, Masaki, Haruna, Miyoshi, Shion, Takeda, Yuichiro, Hojo, Masayuki, Sugiyama, Haruhito
Format: Article
Language:English
Subjects:
Aged, 80 and over
Anesthesia, Local - methods
Arthritis, Rheumatoid - complications
Female
Humans
leg edema
pleural effusion
Pleural Effusion - pathology
Thoracoscopy - methods
thoracoscopy under local anesthesia
yellow nail syndrome
Yellow Nail Syndrome - complications
Yellow Nail Syndrome - diagnosis
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Description
Summary:An 80-year-old woman with rheumatoid arthritis and a past history of tuberculosis presented with exertional dyspnea and edema of both legs. Chest X-ray performed on admission showed bilateral pleural effusion. Thoracoscopy under local anesthesia was performed, and vasodilation and non-specific yellowish inflammatory changes were noted in the pleura. A pathological examination showed chronic fibrosing pleuritis in addition to chronic pleural inflammatory changes with lymphoid aggregates. The nails on all fingers and toes were thickened and displayed yellow discoloration, and the edema was resistant to diuretics. Lymphoscintigraphy was conducted, which showed lymphatic drainage abnormalities. The patient was ultimately diagnosed as having yellow nail syndrome.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.55.5247