Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 16, 2023; 11(8): 1823-1829
Published online Mar 16, 2023. doi: 10.12998/wjcc.v11.i8.1823
Primary membranous nephrotic syndrome with chylothorax as first presentation: A case report and literature review
Le-Le Feng, Jie Du, Chen Wang, Shui-Li Wang
Le-Le Feng, Jie Du, Chen Wang, Shui-Li Wang, Department of Respiratory and Critical Care Medicine I, Shaanxi Provincial People's Hospital, Xi'an 710068, Shaanxi Province, China
Le-Le Feng, Department of Respiratory and Critical Care Medicine I, Xi’an Medical University, Xi'an 710068, Shaanxi Province, China
Author contributions: Feng LL was involved in data collection and analysis, and writing of the manuscript; Du J and Wang C were involved in data verification, student supervision, and manuscript editing; all authors have read and approved the final manuscript.
Supported by the Shaanxi Provincial People’s Hospital Science and Technology Development Incubation Fund Project, No. 2021YJY-33.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: All 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: Shui-Li Wang, Doctor, Chief Physician, Department of Respiratory and Critical Care Medicine I, Shaanxi Provincial People's Hospital, No. 256 Youyi West Road, Beilin District, Xi'an 710068, Shaanxi Province, China. fw0604@163.com
Received: December 13, 2022
Peer-review started: December 13, 2022
First decision: January 17, 2023
Revised: February 1, 2023
Accepted: February 21, 2023
Article in press: February 21, 2023
Published online: March 16, 2023
Processing time: 83 Days and 18.8 Hours
Abstract
BACKGROUND

Primary membranous nephrotic syndrome with chylothorax as the first manifestation is an unusual condition. To date, only a few cases have been reported in clinical practice.

CASE SUMMARY

The clinical data of a 48-year-old man with primary nephrotic syndrome combined with chylothorax admitted to the Department of Respiratory and Critical Care Medicine of Shaanxi Provincial People's Hospital were retrospectively analysed. The patient was admitted to the hospital for 12 d due to shortness of breath. Imaging showed pleural effusion, laboratory tests confirmed true chylothorax, and renal biopsy revealed membranous nephropathy. After primary disease treatment and early active symptom treatment, the prognosis of the patient was good. This case suggests that chylothorax is a rare complication of primary membranous nephrotic syndrome in adults, and early lymphangiography and renal biopsy can assist in the diagnosis when there are no contraindications.

CONCLUSION

Primary membranous nephrotic syndrome combined with chylothorax is rare in clinical practice. We report a relevant case to provide case information for clinicians and to improve diagnosis and treatment.

Keywords: Adult; Chylothorax; Primary nephrotic syndrome; Membranous nephropathy; Pleural effusion; Case report

Core Tip: Chylothorax is a white or milky pleural effusion, and primary membranous nephrotic syndrome is a rare cause of chylothorax. This article reports a case of primary membranous nephrotic syndrome combined with chylothorax and summarizes the relevant cases to raise awareness of chylothorax among clinicians.