Yellow nail syndrome is a very rare disorder that has been noticed since 1927. 1 It affects both sexes equally, with an age of more than 40 years being typical. 2 The exact pathogenesis remains unclear but lymphatic system anatomical and functional abnormalities remain the predominant theory, while other hypotheses suggest autoimmune, cancer, and paraneoplastic roles. 3 Also, a very rare familial case has been reported. 1 Although it is only found in 27%-60% of patients The diagnosis depends on the presence of 2 out; of the characteristic nail changes, respiratory tract infection, and lymphedema. The latter occurs in up to 80% of cases and

Yellow nail syndrome is a rare lymphatic abnormality without a clear pathogenesis. Hereby, we report A 70-year Sudanese female who presented with recurrent cough, recurrent lower limb swelling and yellowish nail discoloration diagnosed as yellow nail syndrome but unfortunately passed away due to acute respiratory distress syndrome (ARDS).