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Disorders of the Pleura |

Chylothorax: A Diagnosis Not Always Apparent FREE TO VIEW

Patricia Castro Acosta, MD; Deisy Barrios Barreto, MD; Paola Arrieta Narvaez, MD; Esteban Perez Rodriguez, PhD; Salvador Diaz Lobato, PhD; Patricia Lazo Meneses, MD; Carolina Gotera, MD
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Hospital Ramón y Cajal, Madrid, Spain


Chest. 2014;145(3_MeetingAbstracts):275A. doi:10.1378/chest.1825083
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Abstract

SESSION TITLE: Pleural Disease/Pleural Effusion Posters

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: Chylothorax is a type of pleural effusion (PE) that occurs infrequently. Chylous fluid appearance is not always present, and the routine inclusion of cholesterol and triglyceride levels is probably necessary.

METHODS: From 1994 to October 2012, 5,896 consecutive PE have been analyzed in the Pleura Unit from our hospital. Of these, 2,558 make up our database. A diagnosis of chylothorax was based on the presence of triglycerides (TGL) pleura / serum> 1, pleura TGL> 110mg/dl and cholesterol pleura / serum <1The statistical analysis used was descriptive stockings, SD and frequencies.

RESULTS: Of the 2,558 PE, 1621 (63%) were male (mean age 65.8) and 937 (36.6%) women (mean age 64.5)Of the PE studied, 69 (2.64%) had TGPE> 110. Of the 69, there were 39 (56.5%) that met the criteria for chylothorax. Of the 30 (43.4%) remaining , 22 were excluded for having TGL pleura / serum <1. Of the PE with a confirmed diagnosis of chylothorax, only 13 had a chylous appearance, followed serofibrinous and purulent (Table N.1) The most frequent etiology of chylothorax were due to malignant, traumatic, liver diseases and miscellaneous (Table No.2)

CONCLUSIONS: The triglyceride level should be studied routinely in all PE. Only 33.3% of the chylothorax pleural effusion, the fluid presents with a chylous appearance. The levels of triglycerides and cholesterol in pleural / serum are also routinely required because of the high occurrence of false negative.

CLINICAL IMPLICATIONS: It’s important to analize the levels of triglycerid and cholesterol in pleural efussion because of the high incidence of false negative. Only 33% of pleural efussion, the fluid presents chylous appereance.

DISCLOSURE: The following authors have nothing to disclose: Patricia Castro Acosta, Deisy Barrios Barreto, Paola Arrieta Narvaez, Esteban Perez Rodriguez, Salvador Diaz Lobato, Patricia Lazo Meneses, Carolina Gotera

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