Lymphoedema Presenting with Pleural Effusion: A Case Report

Abstract

Lymphatic obstruction either congenitally determined (primary) or by a consequence of acquired lymphatic failure
because of obstruction or damaged lymphatics (secondary). Milroy disease is an example of primary lymphoedema
where edema is present at birth or soon thereafter. A 16 year old young boy presented with bilateral leg with scrotal
oedema since birth with ups and downs of his symptoms. According to the statement of the mother the boy was seen by
several physicians and also attended several tertiary hospitals in Dhaka city and eventually was diagnosed as a case of
Milroy disease in 2003. Patient was in a reasonably stable condition till July 2008 when he developed massive pleural
effusion on right side and chylous fluid was aspirated. After that he developed five episodes of right sided pleural
effusion at one to three month interval. Thoracic surgeon was consulted and intra thoracic tube drainage and pleurodesis
was done on 19. 02. 2009. After couple of weeks repeat chest x-ray revealed left sided pleural effusion and again left sided
pleurodesis was performed. He is now clinically stable except mild oedema in his both feet.

DOI: 10.3329/bsmmuj.v3i1.5514

BSMMU J 2010; 3(1): 40-43