Chylothorax congénital : une réponse rapide et totale à la polyvidone iodée

Hmami, F.; Oulmaati, A.; Bouchikhi, C.; Banani, Abdelaziz; Bouharrou, A.

doi:10.1016/j.arcped.2014.06.006

Cited by 8 publications

(10 citation statements)

References 13 publications

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“…Excess iodides may also induce thyrotoxicosis in susceptible individual [13]. Thyroid hormone (TSH, T4, T3) levels were routinely measured just before pleurodesis, and at 24 hours and 72 hours post pleurodesis [2]. In this case, as in the other reported, there was no significant alteration in thyroid function.…”

Section: Discussionsupporting

confidence: 56%

“…It is a rare condition representing 1% -2% of pleural effusions, with a prevalence between 1/8600 and 1/1500 birth [1]. The evolution is unpredictable sometimes leading to an important morbidity, denutrition, dehydration and immune deficiency [2]. The diagnostic is confirmed by the analysis of pleural fluid.…”

Section: Introductionmentioning

confidence: 77%

“…Congenital chylothorax is the most common cause of pleural effusion in the newborn [2]. It can be isolated or associated with other abnormalities of the lymphatic system such as congenital pulmonary lymphagiectasia, a rare developmental disorder involving the lung and characterized by pulmonary subpleural, interlobar, perivascular and peribronchial lymphatic dilatation [6].…”

Section: Discussionmentioning

confidence: 99%

“…In this case, there were no renal toxicity and respiratory status was normal. Surgical treatment is indicated in case of the failure of conservative treatment [2] [6] [10] [13].…”

Section: Discussionmentioning

confidence: 99%

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Congenital Chylothorax: Rapid and Effective Response to Polyvidone Iodine

Maoulainine¹,

Slitine²,

Erguig³

2016

OJPed

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Introduction: Congenital chylothorax, defined by the presence of chyle in the pleural cavity, is a rare congenital disorder of varying severity. The objective of this study was to report a case of idiopathic congenital chylothorax treated with povidone iodine effectively without side effects after failure of conservative treatment by chest drainage. Case presentation: A term female Newborn was admitted in the neonatal intensive care unit at 16 days of life, for respiratory distress. The Clinical examination objectified a Sliverman score of 3/10 with a pleural effusion syndrome. The chest radiography confirmed the pleural effusion and the analysis of the pleural fluid after aspiration confirmed the chylothorax, with a protein rate of 35 g/l, Triglycerids 37 mg/L, and Leukocytes count was 1140/ml with 90% lymphocytes. A chest drainage was performed on the seventh day but followed by the recurrence of the effusion. The use of 5 ml of 4% povidone iodine in the pleural space as a chemical pleurodesis was performed. The clinical and radiological evolution was favorable after 24 hours without relapse or side effects such as allergic reaction or worsening of the respiratory condition. Thoracic ultrasound was performed after 15 days, having objectified minimal right side effusion measuring 5 mm maximum thickness. Conclusion: Chemical pleurodesis by the polyvidone iodine in the chylothorax appears to be affordable and effective, and needs to be more considerate in the conservative treatment of congenital chylothorax.

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Section: Discussionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

“…In this case, there were no renal toxicity and respiratory status was normal. Surgical treatment is indicated in case of the failure of conservative treatment [2] [6] [10] [13].…”

Section: Discussionmentioning

confidence: 99%

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Congenital Chylothorax: Rapid and Effective Response to Polyvidone Iodine

Maoulainine¹,

Slitine²,

Erguig³

2016

OJPed

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“…Bien que rare, le chylothorax représente la cause la plus fréquente des épanchements pleuraux en période néonatale. Son incidence étant estimée à 1/15000 naissances vivantes [ 1 , 4 ]. L'étiologie des chylothorax congénitaux est en général inconnue.…”

Section: Discussionunclassified

Intérêt de la scintigraphie lymphatique et place de la chirurgie dans les chylothorax congénitaux

Methlouthi¹,

Mahdhaoui²,

Bellalah³

et al. 2016

Pan Afr Med J

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Le chylothorax est défini par l'accumulation du liquide lymphatique dans la cavité pleurale. Il existe 3 catégories distinctes chez le nouveau-né: les chylothorax congénitaux (CC), les chylothorax malformatifs ou syndromiques (CM) et les chylothorax post-opératoires (CO). Bien que rare, le chylothorax représente la cause la plus fréquente des épanchements pleuraux en période néonatale. Son diagnostic positif est facile par analyse du liquide pleural, mais son mécanisme et surtout l'intégrité du canal thoracique et ses collatérales est parfois difficile à préciser. La lymphoscintigraphie représente l'examen de choix dans le diagnostic etipathogénique. Ce moyen de diagnostic peut être couplé, si possible, au SPECT-CT (single photon emission tomography/computed tomography) permettant de donner des renseignements plus précis, notamment sur le plan anatomique. Sa prise en charge repose sur le drainage du liquide pleural, la suppression des graisses alimentaires et la nutrition parentérale. Le recours à la chirurgie est préconisé devant l'échec du traitement médical. Nous rapportons l'observation d'un nouveau-né porteur d'un chylothorax unilatéral, n'ayant pas répondu au traitement médical. La lymphoscintigraphie avait permis de diagnostiquer le mécanisme étiopathogénique et par conséquent, de guider le traitement chirurgical.

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Chylothorax in the neonate—A stepwise approach algorithm

Rocha

Arnet

Soares

et al. 2021

Pediatric Pulmonology

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Background Chylothorax in neonates results from leakage of lymph from thoracic lymphatic ducts and is mainly congenital or posttraumatic. The clinical course of the effusion is heterogeneous, and consensus on treatment, timing, and modalities of measures has not yet been established. This review aims to present, along with levels of evidence and recommendation grades, all current therapeutic possibilities for the treatment of chylothorax in neonates. Methods An extensive search of publications between 1970 and 2020 was performed in the PubMed, Cochrane Database of Systematic Reviews, and UpToDate databases. A stepwise approach algorithm was proposed for both congenital and traumatic conditions to guide the clinician in a rational and systematic way for approaching the treatment of neonates with chylothorax. Discussion and Conclusion The treatment strategy for neonatal chylothorax generally involves supportive care and includes drainage and procedures to reduce chyle flow. A stepwise approach starting with the least invasive method is advocated. Progression in the invasiveness of treatment options is determined by the response to previous treatments. A practical stepwise approach algorithm is proposed for both, congenital and traumatic chylothoraces.

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Chylothorax congénital : une réponse rapide et totale à la polyvidone iodée

Cited by 8 publications

References 13 publications

Congenital Chylothorax: Rapid and Effective Response to Polyvidone Iodine

Congenital Chylothorax: Rapid and Effective Response to Polyvidone Iodine

Intérêt de la scintigraphie lymphatique et place de la chirurgie dans les chylothorax congénitaux

Chylothorax in the neonate—A stepwise approach algorithm

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