Saudi Journal of Kidney Diseases and Transplantation

CASE REPORT
Year
: 2012  |  Volume : 23  |  Issue : 1  |  Page : 106--109

Unilateral recurrent pleural effusion in a renal transplant patient


Pooja Binnani, Ruchi Gupta, Nikhil Kedia, MM Bahadur 
 Department of Nephrology, Jaslok Hospital and Research Centre, Mumbai, India

Correspondence Address:
Pooja Binnani
Department of Nephrology, Jaslok Hospital and Research Centre, Mumbai-400026
India

Pleural effusion is a frequent complication in patients undergoing hemodialysis (HD). We report a patient on HD with a novel cause of recurrent unilateral pleural effusion. A 45-year-old female patient on long-term maintenance HD presented to us with recurrent unilateral pleural effusion. She had a history of poor quality dialysis, severe anemia and severe hypertension. Despite correcting these factors and even after undergoing successful renal transplantation, she continued to have recurrent effusion. Left upper extremity venography demonstrated severe stenosis of the subclavian vein and an increased venous flow in the ipsilateral arteriovenous (AV) fistula. Ligation of the AV fistula led to dramatic resolution of the pleural effusion. Hemodialysis patients who develop unexplained pleural effusions ipsilateral to a functioning AV fistula should be investigated for stenosis in the brachiocephalic vein, particularly those patients who have had previous catheterizations of the jugular or subclavian veins on the same side as the effusion. Correcting the stenosis by venous angioplasty and/or ligation of the ipsilateral fistula can dramatically resolve the pleural effusion. A high index of suspicion is required to diagnose this complication for meaningful intervention.


How to cite this article:
Binnani P, Gupta R, Kedia N, Bahadur M M. Unilateral recurrent pleural effusion in a renal transplant patient.Saudi J Kidney Dis Transpl 2012;23:106-109


How to cite this URL:
Binnani P, Gupta R, Kedia N, Bahadur M M. Unilateral recurrent pleural effusion in a renal transplant patient. Saudi J Kidney Dis Transpl [serial online] 2012 [cited 2020 Feb 25 ];23:106-109
Available from: http://www.sjkdt.org/article.asp?issn=1319-2442;year=2012;volume=23;issue=1;spage=106;epage=109;aulast=Binnani;type=0