Rare case of Yellow nail syndrome following multiple orthopedic surgeries: a report

Dr Hideya Itagaki at Department of General Surgery, Honjoudaiichi Hospital, Yurihonnjou Akita, Japan and colleagues have reported a rare case of Yellow nail syndrome following multiple orthopaedic surgeries. The case has appeared in the Journal of Medical Case Reports.

Yellow nail syndrome, also known as "primary lymphedema associated with yellow nails and pleural effusion" is a very rare medical syndrome that includes pleural effusions, lymphedema (due to the underdevelopment of the lymphatic vessels) and yellow dystrophic nails. Approximately 40% will also have bronchiectasis. It is also associated with chronic sinusitis and persistent coughing. It usually affects adults.

A 78-year-old Asian woman presented to our outpatient department with chief complaints of coughing and fever. Her cough had persisted for several weeks, and her fever had developed on the previous day. The patient’s medical history included asthma and sinusitis. Although her sinusitis had been treated several years prior, she had not received treatment before hospitalization. The patient’s surgical history included knee joint replacement and two spinal fusion surgeries; the second spinal fusion had been performed 3 months before the current consultation.

After diagnosis, vitamin E was administered for more than 1 year. After a half-year of vitamin E administration, improvement in the thickness of the nails on the patient’s hands was observed, but no effect was seen for the pleural effusion. Pleural effusion also failed to respond to pleurodesis. Pleural effusion drainage was therefore performed regularly. Currently, the patient visits our clinic every 1–2 months and undergoes chest radiography. Pleural drainage is performed if there is an increase in pleural fluid.

For more details click on the link: https://doi.org/10.1186/s13256-019-2136-2