title: Thoracoscopy under Local Anesthesia was Useful for Diagnosing Yellow Nail Syndrome.
abstract: An 80-year-old woman with rheumatoid arthritis and a past history of tuberculosis presented with exertional dyspnea and edema of both legs. Chest X-ray performed on admission showed bilateral pleural effusion. Thoracoscopy under local anesthesia was performed, and vasodilation and non-specific yellowish inflammatory changes were noted in the pleura. A pathological examination showed chronic fibrosing pleuritis in addition to chronic pleural inflammatory changes with lymphoid aggregates. The nails on all fingers and toes were thickened and displayed yellow discoloration, and the edema was resistant to diuretics. Lymphoscintigraphy was conducted, which showed lymphatic drainage abnormalities. The patient was ultimately diagnosed as having yellow nail syndrome.
authors.affiliation: Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan.
authors.forename: Shoki
authors.initials: S
authors.lastname: Ro
authors.forename: Satoru
authors.initials: S
authors.lastname: Ishii
authors.forename: Yukie
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Konomi
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Haruna
authors.initials: H
authors.lastname: Masaki
authors.forename: Shion
authors.initials: S
authors.lastname: Miyoshi
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Takeda
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hojo
authors.forename: Haruhito
authors.initials: H
authors.lastname: Sugiyama
mesh_terms: D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D001172:Arthritis, Rheumatoid / Q000150:complications; D005260:Female; D006801:Humans; D010996:Pleural Effusion / Q000473:pathology; D013906:Thoracoscopy / Q000379:methods*; D056684:Yellow Nail Syndrome / Q000150:complications / Q000175:diagnosis*