Chylous effusion presenting in a 37-year-old woman with severe hypothyroidism: a case report
1 University of California San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, California 94122, USA
2 Department of Medicine, Santa Clara Valley Medical Center, 751 South Bascom Avenue, San Jose, CA 95128, USA
3 Division of Respiratory and Critical Care Medicine, Santa Clara Valley Medical Center, 5th floor Valley Specialty Building, 751 South Bascom Avenue, San Jose, CA 95128, USA
4 Division of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, California 94305, USA
Journal of Medical Case Reports 2010, 4:336 doi:10.1186/1752-1947-4-336Published: 25 October 2010
We report what is to the best of our knowledge the second adult case of chylothorax clearly associated with severe hypothyroidism in the English-language medical literature. To the best of our knowledge, this is the first case of its kind reported without a prior history of malignancy.
A 37-year-old Hispanic woman with no reported significant past medical history initially presented with shortness of breath and inability to lose weight. She was found to have a large chylous effusion requiring chest-tube drainage, as well as severe hypothyroidism. After several weeks of thyroid hormone-replacement therapy, the formation of chylous pleural fluid in the patient greatly diminished, and the chest tube was removed. Upon long-term follow-up her minimal residual effusion remains stable on serial chest radiographs.
Although the exact pathophysiologic relation between low thyroid hormone levels and chyle formation remains to be elucidated, hypothyroidism should be a diagnostic consideration in patients with chylous effusions, especially those refractory to conventional treatments.