Portacaval transposition produced significant and persistent hypocholesteremia for 2 years in mongrel dogs. At 6 months, the serum cholesterol decreased by 52.5% (p < 0.01) of the normal values and 44% (p < 0.05) at 2 years. The liver function tests showed no significant changes at any period after portacaval transposition. No histological abnormalities were seen either. Although there is no definite explanation for this hypocholesteremic effect, this lowering response in the serum cholesterol after portacaval interposition might be helpful in certain hypercholesteremic conditions.

A 50-year-old man, with a medical history of Chronic Myeloid Leukemia, in relapse treated with dasatinib. Who presents with dyspnea and non-productive cough. Chest x-ray shows left pleural effusion. Diagnostic thoracentesis was performed and 150 ml of pleural fluid was extracted. A sample was sent for analysis, which was compatible with chylothorax. Significant improvement was observed after thoracentesis. In the absence of any other diagnostic alternative, the pleural effusion was attributed to the use of dasatinib.CASE PRESENTATION: A 50-year-old man, with a medical history of Chronic Myeloid Leukemia, diagnosed 4 years ago, currently in relapse, treated with dasatinib. He has not had hospital admissions in the last year. In this hospital admission, he presented dyspnea and non-productive cough without a predominance of schedule. The emergency department does not require supplemental oxygen. The physical examination was notable for the decrease in vesicular murmur in the left lung.DISCUSSION: Upon admission, the laboratory analysis revealed hematology and electrolytes in normal limits. Chest X-ray (Fig. 1) showed left pleural effusion, it was complemented with chest tomography (Fig. 2). There was no evidence of pulmonary or mediastinal lesions, or lymphadenopathy. Thoracentesis was performed, 150 ml of pleural fluid was extracted. Pleural fluid analysis showed triglycerides: 644.72, cholesterol: 59. White blood cells the total count was, PMN: 1.2%, Mononuclear 98, micro proteins: 624 mg / dl, LDH: 105.9. Cytology was negative for malignant cells.CONCLUSIONS: Dasatinib is a tyrosine kinase inhibitor drug, approved for the treatment of chronic myeloid leukemia. Pleural effusion is the most common adverse effect; has an incidence of 7 -40% of cases. Pleural effusion is usually a predominantly lymphocytic exudate, but may occasionally present as chylothorax. Chylothorax has rarely been documented, the grade is variable, and the pathophysiology is not entirely clear. Triglyceride concentration in pleural fluid greater than 110 mg / dl supports the diagnosis. In this case the concentration was greater than 600 mg / dl. There is no current evidence on the relationship of CML with chylothorax, the causes of this type of chylothorax are usually tuberculosis, lymphoma, empyema or biliopleural fistula. Associated infections were ruled out, Obtaining negative cultures, there was no evidence of lesions or pulmonary or mediastinal masses or other associated risk factor, for which the pleural effusion and its characteristics were attributed to the drug. Treatment in this case consisted in reducing the dose of the drug, until therapeutic thoracentesis, with a favorable clinical evolution.

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