Treatment of Chylothorax with Pleurodesis, a Lesser Known Complication of Behçet's Disease: A Case Report

• Published in: Journal of Tehran University Heart Center Vol. 13; no. 4; p. 180
• Main Authors: Demirdaş, Ertan, Atilgan, Kıvanç, Cengiz ER, Zafer, Emre Akin, Süleyman
• Format: Journal Article
• Language: English
• Published: Tehran Tehran University of Medical Sciences 01.10.2018
• Subjects: Behcet syndrome; Behcet's syndrome; Biochemical analysis; Carbohydrates; Case reports; Chest; Chylothorax; Corticoids; Corticosteroids; Diet; Dyspnea; Edema; Immunosuppressive agents; Patients; Radiographs; Respiration; Signs and symptoms; Surgery; Thorax; Thromboembolism; Thrombosis; Vasculitis; Vein & artery diseases; Veins; Veins & arteries
• ISSN: 1735-8620; 2008-2371
• DOI: 10.18502/jthc.v13i4.642

Behçet's Disease (BD) is a multisystemic vasculitis which usually affects optical, genital, and oral mucosae and often reoccurs intermittently. Chylothorax is a very rare complication of BD which usually causes thrombosis in the major venous system. A 27-year-old man with a 10-year history of BD referred to our cardiovascular surgery department with symptoms of serious aches in the left arm, edema, and apparent veins on the left anterior chest wall. A total thrombosis of the left internal and external jugular veins and the left subclavian vein was observed. One month after a successful treatment and discharge, the patient returned to our clinic with symptoms of dyspnea and coughs. A chest radiograph showed a consolidated region. A milky liquid was aspirated through thoracocentesis from the left thorax, and its biochemical analysis helped us arrive at a diagnosis of chylothorax. The patient was hospitalized and administered corticosteroids and immunosuppressive therapy with a high-carbohydrate and low-fat dietary regimen for BD. Thereafter, a left thoracic drainage system was established. On the seventh day of hospitalization, due to a progressing cheilosis flow, a pleurodesis process was applied with talcum powder. However, the chylous drainage was continued and 60 mL of venous autologous blood was injected into the left thorax through a drainage tube. The treatment was successful, and the patient was discharged from the hospital uneventfully. At 1 month’s follow-up, the chest radiograph was normal.