International Economic Institutions

Meerhaeghe, M. A. G. van

doi:10.1007/978-94-017-1930-8

Cited by 6 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Decortication/pleurectomy only had a poor outcome in one patient (6.7%) and it was necessary to perform a pneumonectomy (46). On the other hand, favorable outcomes have been reported (stabilization of symptoms and the size of the PE, and even a spontaneous improvement of the PCT) without having received any type of treatment (2,20,34,35,37). However, the favorable results, possibly very optimistic, should be interpreted with caution, since in the majority of these studies they were associated with various treatments and, sometimes it is difficult to know to which one the favorable outcome was due.…”

Section: Discussionmentioning

confidence: 99%

“…Other treatments were ovarian tumor surgery in a patient with Demons-Meigs syndrome (19), and pneumonectomy in another patient (46), both with a favorable response. Although nine patients did not receive treatment, seven (77.8%) had a favorable outcome (2,20,34,35,37). The reported complications following diagnostic procedures were empyema in eight patients (2,18,38,46,57,64), and bronchopleural fistula in two (35,46).…”

Section: Pementioning

confidence: 99%

See 1 more Smart Citation

Characteristics of patients with pseudochylothorax—a systematic review

Lama¹,

Ferreiro²,

Toubes³

et al. 2016

J. Thorac. Dis.

View full text Add to dashboard Cite

Background: Pseudochylothorax (PCT) (cholesterol pleurisy or chyliform effusion) is a cholesterol-rich pleural effusion (PE) that is commonly associated with chronic inflammatory disorders. Nevertheless, the characteristics of patients with PCT are poorly defined.Methods: A systematic review was performed across two electronic databases searching for studies reporting clinical findings, PE characteristics, and the most effective treatment of PCT. Case descriptions and retrospective studies were included.Results: The review consisted of 62 studies with a total of 104 patients. Median age was 58 years, the male/ female ratio was 2.6/1, and in the 88.5% of cases the etiology was tuberculosis (TB) or rheumatoid arthritis (RA). PE was usually unilateral (88%) and occupied greater than one-third of the hemithorax (96.3%). There was no evidence of pleural thickening in 20.6% of patients, and 14 patients had a previous PE. The pleural fluid (PF) was an exudate, usually milky (94%) and with a predominance of lymphocytes (61.1%). The most sensitive tests to establish the diagnosis were the cholesterol/triglycerides ratio (CHOL/TG ratio) >1, and the presence of cholesterol crystals (97.4% and 89.7%, respectively). PF culture for TB was positive in the 34.1% of patients. Favorable outcomes with medical treatment, therapeutic thoracentesis, decortication/ pleurectomy, pleurodesis, thoracic drainage and thoracoscopic drainage were achieved in 78.9%, 47.8%, 86.7%, 66.6%, 37.5% and 42.9%, respectively.Conclusions: PCT is usually tuberculous or rheumatoid, unilateral and the PF is a milky exudate. The presence of cholesterol crystals and a CHOL/TG ratio >1 are the most sensitive test for the diagnosis. The lack of pleural thickening does not rule out PCT. Treatment should be sequential, treating the underlying causes, and assessing the need for interventional techniques.

show abstract