Pleural effusion associated with ipsilateral breast and arm edema as a complication of subclavian vein catheterization and arteriovenous fistula formation for hemodialysis.
A 38-year-old woman with end-stage kidney disease presented with a pleural effusion and profound edema of the ipsilateral arm and breast. A patent hemodialysis arteriovenous fistula access was present in the involved extremity. Brachiocephalic vein stenosis, as a result of previous dialysis catheter placement in the subclavian vein, was demonstrated by ultrasound imaging and Doppler analysis. Takedown of the arteriovenous fistula in the edematous arm along with living-related kidney transplantation caused immediate resolution of the breast and arm edema and rapid clearing of the effusion. An anatomic explantation for the findings is offered.
Wright
R S
RS
Department of Medicine, UCLA School of Medicine, UCLA Hospital.
Quinones-Baldrich
W J
WJ
Anders
A J
AJ
Danovitch
G M
GM
D000328:Adult; D001132:Arm; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D016121:Brachiocephalic Veins / Q000473:pathology; D001941:Breast Diseases / Q000209:etiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003251:Constriction, Pathologic / Q000150:complications / Q000209:etiology; D004487:Edema / Q000209:etiology*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D010996:Pleural Effusion / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology*; D006435:Renal Dialysis; D013350:Subclavian Vein