Zhang YN, Wang MH, Yu WC, Cheng W, Cong JP, Huang XP, Wang FF. Yellow nail syndrome accompanied by minimal-change nephrotic syndrome: A case report. World J Clin Cases 2022; 10(15): 4949-4956 [PMID: 35801034 DOI: 10.12998/wjcc.v10.i15.4949]
Corresponding Author of This Article
Fang-Fang Wang, Doctor, MD, Attending Doctor, Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao 266000, Shandong Province, China. yaorao1984@163.com
Research Domain of This Article
Respiratory System
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Ya-Nan Zhang, Mei-Hua Wang, Wen-Cheng Yu, Wei Cheng, Jin-Peng Cong, Fang-Fang Wang, Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
Xue-Peng Huang, Department of Respiratory and Critical Care Medicine, People's Hospital of Rizhao Lanshan, Rizhao 276800, Shandong Province, China
Author contributions: Cheng W and Wang MH analyzed and interpreted the patient data regarding the disease; Cong JP and Wang MH performed the histological examination of the pleura and pleural effusion; Huang XP performed the histological examination of kidney; Zhang YN and Wang FF was major contributors in writing the manuscript; Yu WC reviewed and corrected the manuscript; all authors issued final approval for the version to be submitted.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fang-Fang Wang, Doctor, MD, Attending Doctor, Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao 266000, Shandong Province, China. yaorao1984@163.com
Received: October 13, 2021 Peer-review started: October 13, 2021 First decision: December 10, 2021 Revised: December 27, 2021 Accepted: April 3, 2022 Article in press: April 3, 2022 Published online: May 26, 2022 Processing time: 223 Days and 7.3 Hours
Abstract
BACKGROUND
In most cases of yellow nail syndrome (YNS), the classic triad of yellow nails, lymphedema and respiratory manifestations rarely manifest simultaneously. Therefore, diagnosis is delayed or frequently missed.
CASE SUMMARY
We report a 62-year-old YNS patient presenting with bilateral pleural, pericardial and peritoneal effusions who, 2 mo later, developed minimal-change nephrotic syndrome. After treatment with vitamin E, clarithromycin and prednisone for 3 mo, effusions in the chest, pericardium and abdominal cavity decreased while urine protein levels returned to within normal ranges.
CONCLUSION
Clinicians should consider the possibility of YNS for patients presenting with multiple serous effusions and nephrotic syndromes.
Core Tip: Yellow nail syndrome (YNS) is a rare disease characterized by yellow nails, lymphedema and respiratory manifestations. However, few patients have a complete triad. We present a rare case of the classical triad in a patient with concomitant minimal-change nephrotic syndrome. And as far as we know, this is the first report about multiple effusions caused by YNS. This case highlights the variety of clinical manifestations, especially in comorbid cases, leading to delayed or missed diagnosis. Therefore, once YNS is considered, it is recommended to improve relevant examinations of the lymphatic system for further determinations.
