CHYLOTHORAX ASSOCIATED WITH SARCOIDOSIS: A REVIEW OF THE LITERATURE

Lilach Israeli-Shani, Daniel A. King, Gali Epstein Shochet, David Shitrit, Ori Wand

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To review the medical literature regarding chylothorax associated with sarcoidosis. Methods: A literature review of all reported cases of sarcoidosis-associated chylothorax, we included a novel case report to the analysis. Results: Of sixteen cases included in the study, 10 were women (62.5%), mean age 47±17years. In 6 subjects (37.5%) chylothorax was part of the initial presentation of sarcoidosis. Four subjects (25%) additionally suffered from lymphedema and chylous ascites, and one from chylous ascites only. Thoracic lymphadenopathy was reported for 13/16 subjects (81.3%) and lung parenchymal disease in 8/16 (50%). Compression of the thoracic duct was considered as a causative factor in 10 cases (62.5%). One case was attributed to granulomatous pleural inflammation, one to generalized lymphangiectasia, and no specific causative factors were identified in 4 remaining cases (25%). Overall mortality rate was 18.8% (3/16 subjects). Of note, all the subjects treated with corticosteroids survived. Conclusions: Since the association of sarcoidosis with chylothorax is exceedingly rare, alternative etiologies should be pursued even when chylothorax develops in a subject with preexisting sarcoidosis. However, the possibility of sarcoidosis should be entertained when other etiologies for a newly diagnosed chylothorax are ruled out. A multidisciplinary approach is required for optimal management, both for elucidating the diagnosis and for employing therapy, which could be multimodal. A trial of immuno-suppressive therapy with corticosteroids should be considered.

Original languageEnglish
Article numbere2022039
JournalSarcoidosis Vasculitis and Diffuse Lung Diseases
Volume39
Issue number4
DOIs
StatePublished - 1 Dec 2022
Externally publishedYes

Keywords

  • Chylothorax
  • Chylous ascites
  • Lymphedema
  • Pleural effusion
  • Sarcoid

ASJC Scopus subject areas

  • Internal Medicine
  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

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