Abstract
Chylothorax is an uncommon disease where fatty fluid accumulates within the chest cavity. Conservative management, including repeated thoracentesis or pleurodesis, seems to be suitable to most cases. Herein, we present a case of efficacious pleurodesis by intrapleural injection of Sapylin, a streptococcus preparation, for the treatment of chylothorax. A 52-year-old non-smoking female farmer was diagnosed as idiopathic chylothorax after we ruled out possible causes including chest trauma, lymphoma, lung cancer, filariasis, tuberculosis, and etc. Two-time intra-thoracic injection of 3 Klinische Einheit (KE) Sapylin achieved rapid and effective control of chylothorax with no severe side effects. Sapylin may facilitate pleurodesis by producing a strong inflammatory response.
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References
Adachi, H., Hashimoto, T., Komiyama, M., Miyao, Y., Sudou, A., Nakamura, H., Matuoka, T., 2004. Lymphangioleiomyomatosis (LAM) causing chylothorax. Nihon Kokyuki Gakkai Zasshi, 42(1):80–83 (in Japanese).
Dikensoy, O., Light, R.W., 2005. Alternative widely available, inexpensive agents for pleurodesis. Curr. Opin. Pulm. Med., 11(4):340–344. [doi:10.1097/01.mcp.0000166587.24127.91]
Duffy, B.M., Manon, R., Patel, R.R., Welsh, J.S., 2005. A case of Gorham’s disease with chylothorax treated curatively with radiation therapy. Clin. Med. Res., 3(2):83–86.
Fujimura, S., Kondo, T., 2000. The lung transplantation has come to be done in Japan. Kyobu Geka, 53(12):986–991 (in Japanese).
Fujino, A., Moriya, Y., Morikawa, Y., Hoshino, K., Watanabe, T., Shimojima, N., Kitajima, M., 2003. A role of cytokines in OK-432 injection therapy for cystic lymphangioma: an approach to the mechanism. J. Pediatr. Surg., 38(12):1806–1809. [doi:10.1016/j.jpedsurg.2003.08.041]
Jimenez, C.A., Mhatre, A.D., Martinez, C.H., Eapen, G.A., Onn, A., Morice, R.C., 2007. Use of indwelling pleural catheter for the management of recurrent chylothorax in patients with cancer. Chest, 132(5):1584–1590. [doi:10.1378/chest.06-2141]
Koga, K., Mita, Y., Dobashi, K., Masuo, T., Aihara, M., Shimizu, Y., Umegae, Y., Mori, M., 1999. Lung cancer with chylothorax successfully treated by chemical pleurodesis with OK-432. Nihon Kokyuki Gakkai Zasshi, 37(8):627–630 (in Japanese).
Laranne, J., Keshi-Nisula, L., Rautio, R., Rautiainen, M., Airaksinen, M., 2002. OK-432 (Picibanil) therapy for lymphangiomas in children. Eur. Arch. Otorhinolaryngol., 259(5):274–278. [doi:10.1007/s00405-001-0438-6]
Ogita, S., Tsuto, T., Nakamura, K., Deguchi, E., Tokiwa, K., Iwai, N., 1996. OK-432 therapy for lymphangioma in children: why and how does it work? J. Pediatr. Surg., 31(4):477–480. [doi:10.1016/S0022-3468(96)90478-9]
Shimizu, J., Hayashi, Y., Oda, M., Morita, K., Arano, Y., Nagao, S., Murakami, S., Urayama, H., Watanabe, Y., 1994. Treatment of postoperative chylothorax by pleurodesis with the streptococcal preparation OK-432. Thorac. Cardiovasc. Surg., 42(4):233–236.
Tan, C., Sedrakyan, A., Browne, J., Swift, S., Treasure, T., 2006. The evidence on the effectiveness of management for malignant pleural effusion: a systematic review. Eur. J. Cardiothorac. Surg., 29(5):829–838. [doi:10.1016/j.ejcts.2005.12.025]
Tsukihara, A., Tanemura, M., Suzuki, Y., Sato, T., Tanaka, T., Suzumori, K., 2004. Reduction of pleural effusion by OK-432 in a fetus complicated with congenital hydrothorax. Fetal Diagn. Ther., 19(4):327–331. [doi:10.1159/000077960]
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Project (No. 30500229) supported partly by the National Natural Science Foundation of China
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Xu, Zh., Wang, Cf., Zhang, Yq. et al. A case of chylothorax treated curatively with Sapylin, a streptococcus preparation. J. Zhejiang Univ. - Sci. B 8, 885–887 (2007). https://doi.org/10.1631/jzus.2007.B0885
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DOI: https://doi.org/10.1631/jzus.2007.B0885