ABSTRACT

Background: Prevalence of chylothorax (QT) is unknown at INER. Objectives: a) to determine one-year prevalence of chylothorax; b) to describe the characteristics of pleural effusion (PE); c) to determine the etiology of the chylothorax; and; d) to compare the frequency of chylothorax diagnosed by triglycerides (TG ) in PE versus chylothorax frequency by TG determination only in milky pleural effusion. Material and methods: We included patients diagnosed with PE at the hospital entry (2011-2012). We collected samples of PE which were sent to the Clinical Laboratory of the INER. For this study determined the TG mg/dL in PE. Statistical analysis was done according to the distribution of variables. Results: a) One-year prevalence of chylothorax (PE TG› 110 mg/dL) was 5.3%; b) characteristics of PE: 91.5% exudates, transudates 8.5%, mean cholesterol 71.5 (±50) and mean TG 58.5 (±150) mg/dL, c) chylothorax causes: infections and lung cancer, and d) evidence of TG in PE diagnosed 60% more cases of chylothorax versus TG analysis only in milky pleural effusion ([5.1 versus 0.9%], p = 0.0001). Conclusions: One-year prevalence was of chylothorax: 5.3%. The causes of chylothorax were: infections and lung cancer. TG test in DP is useful in diagnosing chylothorax.

KEYWORDS

pleural effusion, chylothorax, triglycerides.

REFERENCES

1. Light RW. Clinical practice. Pleural effusion. N Engl J Med 2002;346:1971-1977.

2. Ryu JH, Tomassetti S, Maldonado F. Update on uncommon pleural effusions. Respirology 2011;16:238-243.

3. Chen E, Itkin M. Thoracic duct embolization for chylous leaks. Semin Intervent Radiol 2011;28:63-74.

4. Skouras V, Kalomenidis I. Chylothorax: diagnostic approach. Curr Opin Pulm Med 2010;16:387-393.

5. Light RW, Macgregor MI, Luchsinger PC, Ball WC Jr. Pleural effusions: the diagnostic separation of transudates and exudates. Ann Intern Med 1972;77:507-513.

6. Romero S, Martin C, Hernandez L, et al. Chylothorax in cirrhosis of the liver: analysis of its frequency and clinical characteristics. Chest 1998;114:154-159.

7. Agrawal V, Doelken P, Sahn SA. Pleural fluid analysis in chylous pleural effusion. Chest 2008;133:1436-1441.

8. Cortés-Telles A, Rojas-Serrano J, Bouscoulet-Torre L. Quilotórax: Frecuencia, causas y desenlaces. Neumol Cir Torax 2010;69:157-162.

9. Maldonado F, Hawkins FJ, Daniels CE, Doerr CH, Decker PA, Ryu JH. Pleural fluid characteristics of chylothorax. Mayo Clin Proc 2009;84:129-133.

10. Doerr CH, Allen MS, Nichols FC 3rd, Ryu JH. Etiology of chylothorax in 203 patients. Mayo Clin Proc 2005;80:867-870.

11. Teng CL, Li KW, Yu JT, Hsu SL, Wang RC, Hwang WL. Malignancy-associated chylothorax: a 20-year study of 18 patients from a single institution. Eur J Cancer Care (Engl) 2012;21:599-605.

12. Davidsen JR, Laursen CB, Madsen PH. Measuring pH in pleural fluid is valuable when identifying the cause of purulent pleural effusion. Ugeskr Laeger 2012;174:1469-1470.

13. Valdés L, San José ME, Pose A, et al. Usefulness of triglyceride levels in pleural fluid. Lung 2010;188:483-489.

14. Agrawal V, Sahn SA. Lipid pleural effusions. Am J Med Sci 2008;335:16-20.

15. Chong SG, Chauhan Z, Di Nino E, Brien AO, Casserly BP. Effusion under the microscope. Monaldi Arch Chest Dis 2012;77:32-34.

16. Carrillo-Esper R, Sosa-García JO, Carrillo-Córdova CA. Chylothorax secondary to gunshot wound. Cir Cir 2009;77:447-449.