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DOI: 10.4103/ajm.AJM_131_18
Sweet hydrothorax: a common presentation of a rare condition
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Abstract
Sweet hydrothorax is a known, yet rare, complication of peritoneal dialysis. It can be life-threatening. This case is about a 70-year-old lady who presented with acute respiratory failure due to massive right-sided hydrothorax that developed insidiously over 3 months of starting peritoneal dialysis. Thoracentesis and technetium scan confirmed the diagnosis. Treatment was successful with hemodialysis.
Key messages
– Peritoneal Dialysis (PD) can be complicated by sweet hydrothorax.
– Symptoms onset after initiation of PD and symptoms resolve with its discontinuation suggest the diagnosis.
– High gradient glucose level between pleural fluid and plasma is a hallmark feature of sweet hydrothorax.
– Patients with life-threatening symptoms can consider hemodialysis or surgical options.
Keywords
Diaphragmatic defect - peritoneal dialysis - pleural effusion - pleuroperitoneal communication - sweet hydrothorax - technetium scanPublication History
Article published online:
09 August 2021
© 2019. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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References
- 1 Yeates K, Zhu N, Vonesh E, Trpeski L, Blake P, Fenton S. Hemodialysis and peritoneal dialysis are associated with similar outcomes for end-stage renal disease treatment in Canada. Nephrol Dial Transplant 2012; 27: 3568-75
- 21 Gidaris D, Printza N, Batzios S, BelechriBelechri AM, Papachristou F. A “sweet” hydrothorax in a child on peritoneal dialysis. Hippokratia 2011; 15: 358-60
- 3 Lepage S, Bisson G, Verreault J, Plante GE. Massive hydrothorax complicating peritoneal dialysis. Isotopic investigation (peritoneopleural scintigraphy). Clin Nucl Med 1993; 18: 498-501
- 4 Nomoto Y, Suga T, Nakajima K, Sakai H, Osawa G, Ota K. et al. Acute hydrothorax in continuous ambulatory peritoneal dialysis—a collaborative study of 161 centers. Am J Nephrol 1989; 9: 363-7
- 5 Tang S, Chui WH, Tang AW, Li FK, Chau WS, Ho YW. et al. Video-assisted thoracoscopic talc pleurodesis is effective for maintenance of peritoneal dialysis in acute hydrothorax complicating peritoneal dialysis. Nephrol Dial Transplant 2003; 18: 804-8
- 6 Clattenburg E, Bhatnagar A, Perfetto C, McNabney M. Not so “sweet”: An unusual case of dyspnea in an older woman on peritoneal dialysis. J Am Geriatr Soc 2014; 62: 409-10
- 7 Chow KM, Szeto CC, Wong TY, Li PK. Hydrothorax complicating peritoneal dialysis: Diagnostic value of glucose concentration in pleural fluid aspirate. Perit Dial Int 2002; 22: 525-8
- 8 Szeto CC, Chow KM. Pathogenesis and management of hydrothorax complicating peritoneal dialysis. Curr Opin Pulm Med 2004; 10: 315-9
- 9 Smolin B, Henig I, Levy Y. “Sweet” hydrothorax complicating chronic peritoneal dialysis. Eur J Intern Med 2006; 17: 583-4
- 10 Maude RR, Barretti M. Severe “sweet” pleural effusion in a continuous ambulatory peritoneal dialysis patient. Respir Med Case Rep 2014; 13: 1-3