title: Beta-2-transferrin to detect cerebrospinal fluid pleural effusion: a case report.
abstract: BACKGROUND
  Pleural effusion secondary to ventriculoperitoneal shunt insertion is a rare and potentially life-threatening occurrence.
  
  
  METHODS
  We describe a 14-month-old Caucasian boy who had a ventriculoperitoneal shunt inserted for progressive hydrocephalus of unknown etiology. Two and a half months post-shunt insertion, the patient presented with mild respiratory distress. A chest radiograph revealed a large right pleural effusion and a shunt series demonstrated an appropriately placed distal catheter tip. A subsequent abdominal ultrasound revealed marked ascites. Fluid drained via tube thoracostomy was sent for beta-2-transferrin electrophoresis. A positive test was highly suggestive of cerebral spinal fluid hydrothorax. Post-externalization of the ventriculoperitoneal shunt, the ascites and pleural effusion resolved.
  
  
  CONCLUSIONS
  Testing for beta-2-transferrin protein in pleural fluid may serve as a useful technique for diagnosing cerebrospinal fluid hydrothorax in patients with ventriculoperitoneal shunts.
authors.affiliation: Division of Pediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, University of Toronto Toronto Canada.
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Smith
authors.forename: Eyal
authors.initials: E
authors.lastname: Cohen