Yellow nail syndrome: Recurrent pleural effusion in a patient with severe chronic obstructive pulmonary disease

Abstract

Recurrent pleural effusion of unrevealed etiology is important problem in clinical practice. Yellow nail syndrome (YNS) is a rare disorder, which consists of the triad of deformed yellow nails, lymphedema and respiratory disorder. It is often accompanied with bronchiectasis, pleural effusion and/or chronic rhinosinusitis. Frequently, only two of three features are present. The exact mechanism of YNS remains unknown. However, it is thought to reflect functional defects in the lymphatic vasculature. We report on a case of yellow nail syndrome in a 75-year old man, heavy smoker, treated for exacerbation of chronic obstructive pulmonary disease and chronic hypercapnic respiratory failure. He had characteristic nail changes and recurrent pleural effusion of the unknown etiology until the exudation was put into connection with YNS.