Treatment with OK-432 for persistent congenital chylothorax in newborn infants resistant to octreotide

Matsukuma, Eiji; Aoki, Yusuke; Sakai, Miho; Kawamoto, Norio; Watanabe, H.; Iwagaki, Shigeki; Takahashi, Yuichiro; Kawabata, Ichiro; Kondo, Naomi; Uchida, Yasushi

doi:10.1016/j.jpedsurg.2008.12.008

Cited by 38 publications

(36 citation statements)

References 15 publications

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“…1 OK-432, an inactive preparation of Streptococcus pyogenes, has also been used as an effective sclerosing agent in neonates. 144,145 OK-432-induced pleurodesis has been used as an antenatal treatment of severe chylothorax associated with nonimmunologic hydrops fetalis. 146,147 Pleurodesis is performed with thoracoscopy, although the sclerosing agent can be instilled through a chest tube.…”

Section: Figurementioning

confidence: 99%

Chylothorax in Infants and Children

2014

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Chylothorax, the accumulation of chyle in the pleural space, is a relatively rare cause of pleural effusion in children. It can cause significant respiratory morbidity, as well as lead to malnutrition and immunodeficiency. Thus, a chylothorax requires timely diagnosis and treatment. This review will first discuss the anatomy and physiology of the lymphatic system and discuss various causes that can lead to development of a chylothorax in infants and children. Then, methods of diagnosis and treatment will be reviewed. Finally, complications of chylothorax will be reviewed. Pediatrics 2014;133:722-733

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Section: Figurementioning

confidence: 99%

Chylothorax in Infants and Children

2014

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“…87,88 Intrapleural administration of OK-432 has been reported to have favorable outcomes in the management of fetal chylothorax. [40][41][42][43] Kim et al 89 and Matsukuma et al 90 reported effective use of OK-432 in neonatal cases (two cases each) refractory to conservative management. Fever lasting for 2-4 days and a local inflammatory reaction lasting 3-7 days are the reported side effects.…”

Section: Ok-432 (Picibanil)mentioning

confidence: 99%

Congenital chylothorax: current perspectives and trends

Krishnamurthy

Malhotra

2017

RRN

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Congenital chylothorax (CC) is the most common cause of pleural effusion in the perinatal period. The etiology is unknown in the majority of the cases. However, in some cases, it can be associated with various syndromes and genetic conditions. CC is associated with a high mortality rate. Most of the clinical manifestations are secondary to pressure effects (pulmonary hypoplasia) and loss of protein and lymphatic fluid (hydrops, malnutrition). Conservative management in the neonatal period is effective in up to 80% of cases and includes pleural drainage, parenteral nutrition/enteral medium-chain triglyceride-based formulae, and medications such as octreotide. Surgical intervention (pleurodesis, thoracic duct ligation/embolization, pleuroperitoneal shunt) may be required in persistent cases. A universal consensus on management of CC is unavailable, and data on the safety of medication use for CC in neonates are sparse.

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“…Another option is to inject chemical compounds such as cytostatic drugs, tetracycline, povidon-iodine or talcum in the pleural cavity [7]. Finally, also biological compounds like a low virulent streptococcus pyogenes strain (OK-432) or, as in this case blood, can have the same effect [8].…”

Section: Introductionmentioning

confidence: 99%

Cessation of severe chylothorax and chylous ascites in a newborn with trisomy 21 after whole blood pleurodesis: A case report

Rützel¹,

Gebauer²,

Pulzer³

et al. 2017

Pediatr Dimensions

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We present a case of a newborn with trisomy 21 and congenital lymphatic malformation leading to severe chylothorax and chylous ascites, which was successfully treated with autologous blood pleurodesis. Other established measures like adaptet enteral nutrition, parenteral nutrition, octreotide therapy and operative pleurodesis failed to decrease pleural fluid secretion beforehand.The second interesting aspect of this case is the fact, that intragastrally administered methylene blue resulted in a profound staining of the complete body. This is, to our knowledge, the fist surviving child of this constellation reported in the literature.

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Treatment with OK-432 for persistent congenital chylothorax in newborn infants resistant to octreotide

Cited by 38 publications

References 15 publications

Chylothorax in Infants and Children

Chylothorax in Infants and Children

Congenital chylothorax: current perspectives and trends

Cessation of severe chylothorax and chylous ascites in a newborn with trisomy 21 after whole blood pleurodesis: A case report

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