Tuberc Respir Dis.  2009 Dec;67(6):565-568.

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

• Noh SH
• Park GM
• Chun YH
• Kim SY
• Roh JH
• Park TS
• Kim WS

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.

Keyword

Pleural Effusion; Yellow Nail Syndrome; Lymphedema

MeSH Terms

Aged
Bronchiectasis
Bronchitis, Chronic
Drainage
Female
Humans
Lymphedema
Lymphoscintigraphy
Nails
Pleural Effusion
Sinusitis
Yellow Nail Syndrome

Figure

• 

  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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