Case-based discussion from North Tyneside General Hospital: somatostatin analogues in.yellow nail syndrome associated with recurrent pleural effusions

摘要

Kristian Brooks (KB): A 77-year-old man presented to accident and emergency with a 1-month history of progressive breathlessness and reduced exercise tolerance. He had no chest pain, cough or wheeze, but had bilateral leg swelling and 4 kg weight loss. He had long-standing nail dystrophy and, following presentation with recurrent lower respiratory tract infections several years previously, bronchiectasis had been confirmed on high-resolution CT. He was a lifelong non-smoker, but had significant occupational asbestos exposure. There was no relevant family history. Chest radiograph showed large bilateral pleural effusions. Blood tests, including markers of infection and inflammation, were unremarkable. An ultrasound-guided pleural tap showed a lymphocytic exudate.