PDF(Pubmed)
Abstract：
Yellow nail syndrome (YNS) can induce bilateral exudative pleural effusion; however, to the best of our knowledge, no standard treatment for YNS has been established. The present study describes a patient with YNS for whom the pleural effusion was controlled by prednisolone. A 73-year-old man was referred to the University of Tsukuba Hospital (Ibaraki, Japan) complaining of shortness of breath, which was diagnosed as being due to bilateral pleural effusion. Based on the presence of yellowing and growth retardation of the toenails, lymphedema, bilateral exudative pleural fluid of unknown etiology, and lymphatic congestion on lymphoscintigraphy, the patient was diagnosed with YNS. The pleural fluid was predominantly lymphocytic and responded to systemic steroid administration [prednisolone 30 mg/day (0.5 mg/kg) for 2 weeks, with subsequent weekly tapering]. The general condition of the patient and their dyspnea also improved with treatment. These findings indicated that systemic steroid administration should be considered as one of the treatment options for patients with YNS who are reluctant to undergo chest drainage or pleurodesis due to the potential for a decrease in their ability to perform daily activities and respiratory function.
摘要：
黄甲综合征(YNS)可诱发双侧渗出性胸腔积液;据我们所知,尚未建立YNS的标准治疗方法。本研究描述了一名YNS患者，其胸腔积液由泼尼松龙控制。一名73岁的男子被转介到筑波大学医院(茨城县，日本)抱怨呼吸急促，被诊断为双侧胸腔积液。基于脚趾甲泛黄和生长迟缓的存在，淋巴水肿,病因不明的双侧渗出性胸水，和淋巴闪烁显像上的淋巴充血，患者被诊断为YNS。胸腔积液主要是淋巴细胞性的，对全身性类固醇给药有反应[泼尼松龙30mg/天（0.5mg/kg），持续2周，随后每周缩减]。患者的一般状况和他们的呼吸困难也随着治疗而改善。这些发现表明，全身性类固醇给药应被视为YNS患者的治疗选择之一，这些患者由于可能降低其执行日常活动和呼吸功能的能力而不愿进行胸腔引流或胸膜固定术。
