Pleural effusions in the neonate

Rocha, Gustavo; Fernandes, Paula Cristina; Rocha, Paula; Quintas, Conceição; Martins, Teresa; Proença, Elisa

doi:10.1080/08035250500477545

Cited by 70 publications

(61 citation statements)

References 18 publications

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“…A review of literature found a rate of diagnosis of 1 in 7000 to 1 in 10 000. [7][8][9] In our cohort the incidence was approximately 1 in 5800 live births. There is a suggestion that more infants are being diagnosed with this condition as compared with previously reported literature, mainly due to increase in complex cardiac surgeries in this population.…”

Section: Discussionmentioning

confidence: 66%

Congenital chylothorax: Associations and neonatal outcomes

Downie

Sasi

Malhotra

2013

J Paediatrics Child Health

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Aim Congenital chylothorax is a rare but significant neonatal entity with major morbidity and mortality. The study aims to describe the related associations, management and outcomes of this condition in neonates. Methods This is a retrospective case series of all cases of congenital chylothorax admitted to a tertiary neonatal centre in the last 15 years. Results Ten cases of congenital chylothorax were identified. Eight infants were diagnosed antenatally and three infants had antenatal pleural drainage. Most infants were ventilated at birth and required immediate pleurocentesis. Post‐natal management included drainage of fluid, ventilation, albumin replacement, octreotide and dietary modification with medium‐chain triglyceride‐enriched formula. Five infants had chromosomal aberrations identified, while a further two had dysmorphic features not substantiated with routine genetic testing. Noonan's syndrome was the single most common underlying genetic diagnosis. Associated anomalies and malformations were present in 80% of the cohort. There were two deaths in the series, both in infants with multiple co‐morbidities. Conclusions Congenital chylothorax is a rare condition with overall prevalence of less than a case per year in our experience. Majority of infants had associated chromosomal anomalies and significant co‐morbidities needing prolonged intensive care.

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Section: Discussionmentioning

confidence: 66%

Congenital chylothorax: Associations and neonatal outcomes

Downie

Sasi

Malhotra

2013

J Paediatrics Child Health

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“…71 Idiopathic chylothorax including congenital chylothorax is the third most common in the neonate, and is the most frequent cause of pleural effusion. 72 Congenital chylothorax is more frequent in males (2:1) and on the right side of the thorax. Thoracotomies have shown that the thoracic duct is normal in most of the afflicted babies, and occasionally generalized oozing is described.…”

Section: Chylous Pleural Effusionsmentioning

confidence: 99%

“…64,73 It may be isolated or part of a larger group of lymphatic abnormalities and it has also been associated with Turner's, Down and the Noonan syndromes. 64 Familial congenital chylothorax has been reported in both males 72 and females. 74 The fourth chylothorax category is "other disorders" (e.g., lymphangioleiomyomatosis, tuberculosis, sarcoidosis, KS).…”

Section: Chylous Pleural Effusionsmentioning

confidence: 99%

Lymphatics in Lung Disease

El–Chemaly

Levine

Moss

2008

Annals of the New York Academy of Sciences

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The lymphatic circulation appears to be a vital component in lung biology in health and in disease. Animal models have established the role of the lymphatic circulation in neoplastic and inflammatory diseases of the lung, such as asthma and cancer, and allowed for the understanding of the molecular controls of lymphangiogenesis in normal lung development. Understanding the role of lymphatics in human lung disease appears likely to contribute to the understanding of the pathogenesis of disease and the development of novel therapeutic targets. Keywords lymphangiogenesis; metastasis; lymphangiectasis; lymphangioleiomyomatosis; VEGF-D; VEGF-CThe lymphatic circulation has received little attention in pulmonary research. Fluid homeostasis and host defense are two critical roles for the lung, in addition to gas exchange. 1 The main function of the lymphatic circulation is to drain fluid from tissues and return it to the vascular circulatory system. 2 The lymphatic circulation is also involved in the immune system of the body, since lymphocytes and dendritic cells move through the lymphatic system to reach the lymphoid organs. 2 Therefore, the lymphatic circulation must be a vital component in lung biology in health and in disease.The lymphatic system comprises a vasculature consisting of thin-walled capillaries as well as larger vessels that are lined by a layer of endothelial cells. Lymphatics structures are distinguished from those of the arterial and venous circulations by the absence of pericytes. 3 Identification of unique lymphatic markers that differentiate its vessels from the arterial and venous circulations enabled a more informed study of the lymphatic circulation.Among the most important markers are:1. Prox1, which is found exclusively in the lymphatic endothelium, and is a transcription factor required for programming the phenotype of the lymphatic endothelial cell (LEC) 4 ;2. LYVE-1, a CD44 homologue, and an LEC hyaluronan receptor, which is present exclusively on LECs and macrophages 5 ; and

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“…Antibiotics should be given until an infectious etiology has been excluded. [911] Antenatally diagnosed pleural effusions, particularly if present prior to 32 weeks gestation, have a mortality rate as high as 55%. [1213] Bilateral pleural effusions are frequently associated with pulmonary hypoplasia.…”

Section: Discussionmentioning

confidence: 99%