Quilopericárdio idiopático primário: relato de caso

Abstract

Pericardial effusions; chylopericardium idiopathic primary.The accumulation of chyle in the pericardial space, or chylopericardium, is a condition occurring most frequently after trauma, cardiac and thoracic surgery, or in association with tumors, tuberculosis or lymphangiomatosis. When its precise cause cannot be identified, it is called primary or idiopathic chylopericardium. This is a rare clinical entity. We report the case of a surgically treated 20-year-old female patient. A brief review of the literature and comments on the clinical presentation, etiopathogenesis, ancillary diagnostic tests and treatment options are also presented.Pericardial biopsy -fibrous thickening and mesothelial reaction. Laboratory tests:Blood -total cholesterol 140 mg/dl; LDL-cholesterol 62 mg/dl; triglycerides 70 mg;dl.Pericardial fluid -triglycerides 1,420 mg/dl; culture-sterile; Gram-staining-absence of bacteria, rare leukocytes; cytology -global count: erythrocytes 2.6 x 10 3 /mm 3 ; leukocytes 3.2 x 10 3 /mm 3 ; differential count: lymphocytes 3%; monocytes 8%; segmented neutrophils 89%.Lymphoscintigraphy performed 14 days after pericardial drainage showed lower limbs with normal aspect and abnormal thoracic radiopharmaceutical accumulation, which e40 Case Report Silva et al Primary idiopathic chylopericardium Arq Bras Cardiol 2009; 92(6) : e40-e43 Primary idiopathic chylopericardium Arq Bras Cardiol 2009; 92(6) : e40-e43