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Case Report
Published: 02-07-2022

Terapia nutricional de quilotórax bilateral secundário à doença de Hodgkin: um relato de caso

Departamento de Clínica Médica e Equipe Multidisciplinar de Terapia Nutricional do Instituto Mario Penna. Belo Horizonte/MG, Brasil
Departamento de Clínica Médica do Instituto Mario Penna. Mestre em Infectologia e Medicina Tropical pela Faculdade de Medicina da Universidade Federal de Minas Gerais (UFMG). Belo Horizonte/MG, Brasil
Chylothorax Lymphoma Nutritional therapy Medium-chain triglyceride

Abstract

Chylothorax is defined as the accumulation of triglyceride-rich fluid in the pleural space. It is a condition with several possible etiologies, the prognosis is poor and mortality is high when associated with malignancies. This report describes a rare case of bilateral chylothorax in a 59 years old man, secondary to relapsed Hodgkin’s lymphoma, with emphasis on nutritional management. Due to the presence of moderate malnutrition prior to admission, defined by the Subjective Global Assessment, opted for exclusive peripheral parenteral nutrition associated with chemotherapy, with significant improvement. Oral medium chain triglycerides (MCT) were not offered.

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References

  1. Doerr CH, Miller DL, Ryu JH. Chylothorax. Semin Respir Crit Care Med. 2001;22:61-7.
  2. Doerr CH, Allen MS, Nichols FC III, et al. Etiology of chylothorax in 203 patients. Mayo Clin Proc. 2005;80:867-70.
  3. McWilliams A, Gabbay E. Chylothorax ocurring 23 years post-irradiation: literature review and management strategies. Respirology. 2000;5:301-3.
  4. Iqbal MH, Smith PR, Bande S. Chylothorax due to angioimmunoblastic T-cell lymphoma. Intern J Med. 2009;39:67-8.
  5. McGrath EE, Blades Z, Anderson PB. Chylothorax: etiology, diagnosis and therapeutic options. Respir Med. 2010;104:1-8.
  6. O’Callaghan AM, Mead GM. Chylothorax in lymphoma: mechanisms and management. Ann Oncol. 1995;6:603-7.
  7. Janjetovic S, Janning M, Daukeva L, Bokemeyer C, Fiedler W. Chylothorax in a patient with Hodgkin’s lymphoma: a case report and review of the literature. Tumori. 2013;99:99-6.
  8. Schild H, Strassburg CP, Welz A, Kalff J. Treatment options in chylothorax. Dtsch Arztebl Int. 2013; 110(48):819-26.
  9. Orange JS, Geha RS, Bonilla FA. Acute chylothorax in children: selective retention of memory T cells and natural killer cells. J Pediatr. 2003;143(2):243-9.
  10. Agrawal V, Doelken P, Sahn SA. Pleural fluid analysis in chylous pleural effusion. Chest. 2008;133:1436-41.
  11. Maldonado F, Hawkins FJ, Daniels CE, et al. Pleural fluid characteristics of chylothorax. Mayo Clin Proc. 2009;84:129-33.
  12. Staats BA, Ellefson RD, Budahn LL, et al. The lipoprotein profile of chylous and nonchylous pleural effusions. Mayo Clin Proc. 1980;55:700-70.
  13. Jensen GL, Mascioli EA, Meyer LP, et al. Dietary modification of chyle composition in chylothorax. Gastroenterology. 1989;97:761-5.
  14. Machado JD, Suen VM, Marchini JS. Is oral nutritional therapy effective for the treatment of chylothorax? A case report. Nutrition. 2008;24:607-9.
  15. Takuwa T, Yoshida J, Ono S, et al. Low-fat diet management strategy for chylothorax after pulmonary resection and lymph node dissection for primary lung cancer. J Thorac Cardiovasc Surg. 2013;146:571-4.
  16. Fernández Alvarez JR,Kalache KD, Grauel EL. Manegement of spontaneus congenital chylothorax: oral medium-chain triglycerides versus total parenteral nutrition. Am J Perinatol. 1999;16:415-20.
  17. Demos NJ, Kozel J, Scerbo JE. Somatostatin in the treatment of chylothorax. Chest. 2001;119:964-6.
  18. Evans J, Clark MF, Mincher L, Varney VA. Chylous effusions complicating lymphoma: a serious event with octreotide as a treatment option. Hematol Oncol. 2003; 21:77-81.
  19. Mincher L, Evans J, Jenner MW, Varney VA. The successful treatment of chylous effusions in malignant disease with octreotide. Clin Oncol (R Coll Radiol). 2005;17:118-21.
  20. Nair SK, Petko M, Hayward MP. Aetiology and management of chylothorax in adults. Eur J Cardiothorac Surg. 2007;32:362-9.
  21. Breaux J, Marks C. Chylothorax causing reversible T-cell depletion. J Trauma. 1988;28:705-7.

How to Cite

Ferreira, B. M. N. R., & Pereira, A. C. G. (2022). Terapia nutricional de quilotórax bilateral secundário à doença de Hodgkin: um relato de caso. International Journal of Nutrology, 9(4), 237–241. https://doi.org/10.1055/s-0040-1705638