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Noh, Park, Chun, Kim, Roh, Park, and Kim: A Case of Yellow Nail Syndrome Manifesting as Chronic Recurrent Pleural Effusion
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2009; 67(6): 565-568.

Published online: 31 December 2009

DOI: https://doi.org/10.4046/trd.2009.67.6.565

A Case of Yellow Nail Syndrome Manifesting as Chronic Recurrent Pleural Effusion

Se Hui Noh, M.D., Gyung-Min Park, M.D., Yoon Hee Chun, M.D., Sun Young Kim, M.D., Jae Hyung Roh, M.D., Tai Sun Park, M.D., Woo Sung Kim, M.D., Ph.D.

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Address for correspondence: Woo Sung Kim, M.D. Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap-2-dong, Songpa-gu, Seoul 138-736, Korea. Phone: 82-2-3010-3133, Fax: 82-2-3010-6968, wskim2@amc.seoul.kr

Received 21 October 2009       Accepted 22 October 2009

Copyright©2009. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Yellow nail syndrome is a rare cause of pleural effusions. This syndrome is characterized by yellow discoloration of nails, lymphedema, and respiratory disorders, including pleural effusion, chronic bronchitis, bronchiectasis, and chronic sinusitis. The etiology of this syndrome is obscure, but the pathogenesis seems to be related with impaired lymphatic drainage. We report a case of yellow nail syndrome in a 70-year-old female with the typical clinical findings (yellow discoloration of nails, lymphedema, and chronic pleural effusion) of this disorder and with proven lymphatic obstruction on lymphoscintigraphy.

Keywords: Pleural Effusion, Yellow Nail Syndrome, Lymphedema

Figures and Tables

Figure 1
(A) Lymphedema of both legs. (B, C) Characteristic nail changes showing yellow discoloration, prominent horizontal and transverse ridges, and loss of both lunulae and cuticles.
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Figure 2
(A) Chest X-ray shows large amount of pleural effusion in left hemithorax and right pleural thickening. (B) Chest CT shows large amount of pleural effusion in left hemithorax and right pleural thickening with calcification (sequela of previous tuberculous pleuisy).
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Figure 3
Markedly delayed lymphatic flow in both lower extremities on 8 hour delayed lymphoscintigraphy image.
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