S-229 : Pleural effusion from toxocariasis with no serum eosinophila

등록일 2015.11.06 | 최종수정일 2016.07.21 파일확장자어도비 PDF (pdf) | 1페이지 | 가격 1,000원
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발행기관 : 대한내과학회 수록지정보 : 대한내과학회 추계학술발표논문집 / 2015권 / 1호
저자명 : ( Min Ji Cho ) , ( Dong Il Park ) , ( Ju Ock Kim ) , ( Sung Soo Jung ) , ( Hee Sun Park ) , ( Da Hyun Kang )

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An 85-year-old male was admitted complaining of mMRC grade 2 dyspnea. A chest x-ray showed a left pleural effusion (Fig. 1A). There was no serum eosinophilia and the pleural effusion showed mononuclear cell dominant exudates with no malignant cells. Four months later, the patient was readmitted with the same symptoms; The chest x-ray revealed a progressed left loculated effusion (Fig. 1B). A pleural biopsy and pleural fluid examination were performed; the biopsy showed chronic active inflammation with no specific findings. But at that time, we missed the results of the eosinophilic effusion. Subsequently, the patient visited the hospital and underwent repeat thoracenteses. Over time, the rate of pleural effusion accumulation accelerated (Fig. 1C). No serum eosinophilia was detected throughout the follow-up period. We conducted a chart review, and at this time, the missed eosinophilic pleural effusion was detected and then we could estimate his disease as parasite infection. Serum toxocariasis antibody tests using an ELISA were positive. The patient was prescribed albendazole. Follow-up visit after 6 months, his dyspnea had resolved and the loculated pleural effusionhad not progressed (Fig. 1D). All toxocariasis patients in published case reports had serum eosinophilia. This is the first case report of an eosinophilic pleural effusion without serum eosinophilia. Therefore, an antibody ELISA can be useful for diagnosing toxocariasis in patients with a pleural effusion of unknown cause, even in the absence of serum eosinophilia.

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