Email updates

Keep up to date with the latest news and content from Journal of Medical Case Reports and BioMed Central.

Open Access Case report

Chylous effusion presenting in a 37-year-old woman with severe hypothyroidism: a case report

Kevin SH Koo1, Rand Barnard2, Frank T Kagawa3*, Weichia Chen4 and Irma Hinojosa

Author Affiliations

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

For all author emails, please log on.

Journal of Medical Case Reports 2010, 4:336  doi:10.1186/1752-1947-4-336

Published: 25 October 2010

Abstract

Introduction

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.

Case presentation

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.

Conclusion

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.