Bucillamine-induced Yellow Nail Syndrome with Chylothorax: A Case Report

Yukari Hisamoto; Yoriyuki Murata; Kazuki Matsuda; Koji Narikiyo; Taiga Kobayashi; Kosei Yonezawa; Keita Murakawa; Kazuki Hamada; Syuichiro Ohata; Toshiaki Utsunomiya; Yoshikazu Yamaji; Keiji Oishi; Maki Asami-Noyama; Nobutaka Edakuni; Tomoyuki Kakugawa; Tsunahiko Hirano; Kazuto Matsunaga

doi:10.2169/internalmedicine.4935-24

Yukari Hisamoto, Yoriyuki Murata, Kazuki Matsuda, Koji Narikiyo, Taiga Kobayashi, Kosei Yonezawa, Keita Murakawa, Kazuki Hamada, Syuichiro Ohata, Toshiaki Utsunomiya, Yoshikazu Yamaji, Keiji Oishi, Maki Asami-Noyama, Nobutaka Edakuni, Tomoyuki Kakugawa, Tsunahiko Hirano, Kazuto Matsunaga

Author information

Yukari Hisamoto
The Department of Respiratory Medicine, National Hospital Organization Yamaguchi-Ube Medical Center, Japan
Yoriyuki Murata
The Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Japan
Kazuki Matsuda
The Department of Respiratory Medicine, Japan Community Health care Organization Tokuyama Central Hospital, Japan
Koji Narikiyo
The Department of Radiology,Graduate School of Medicine, Yamaguchi University, Japan
Taiga Kobayashi
The Department of Radiology,Graduate School of Medicine, Yamaguchi University, Japan
Kosei Yonezawa
The Department of Respiratory Medicine, National Hospital Organization Yamaguchi-Ube Medical Center, Japan
Keita Murakawa
The Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Japan
Kazuki Hamada
The Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Japan
Syuichiro Ohata
The Department of Respiratory Medicine, Japan Community Health care Organization Tokuyama Central Hospital, Japan
Toshiaki Utsunomiya
The Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Japan
Yoshikazu Yamaji
The Department of Respiratory Medicine, Japan Community Health care Organization Tokuyama Central Hospital, Japan
Keiji Oishi
The Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Japan
Maki Asami-Noyama
The Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Japan
Nobutaka Edakuni
The Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Japan
Tomoyuki Kakugawa
The Department of Pulmonology and Gerontology, Graduate School of Medicine, Yamaguchi University, Japan
Tsunahiko Hirano
The Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Japan
Kazuto Matsunaga
The Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Japan

Keywords: Yellow nail syndrome, Bucillamine, Chylothorax, Lymphangiography

JOURNAL OPEN ACCESS Advance online publication

Article ID: 4935-24

DOI https://doi.org/10.2169/internalmedicine.4935-24

Details

Abstract

Yellow nail syndrome (YNS), a rare condition characterized by thickened yellow nails, lymphedema, and respiratory manifestations, is rarely caused by bucillamine, an anti-rheumatic agent. Respiratory manifestations of YNS include chylothorax in 18.8%-22% of patients with pleural effusion. We herein report the first case of bucillamine-induced YNS with chylothorax. Lymphangiography revealed narrowing of the lymphatic vessels and stagnation of the lymphatic fluid, suggesting impaired lymphatic drainage. The chylothorax persisted despite the discontinuation of bucillamine. The present case illustrates that bucillamine can cause irreversible lymphatic impairment and chylothorax.

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