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Case Reports
. 2018 Apr 5;18(1):127.
doi: 10.1186/s12887-018-1101-3.

Chylopericardium in a child with IgA nephropathy: a case report

Yu-Lin Kang  1 , Yun Cui  2 , Ying Wu  1 , Shen Hao  1 , Xin-Yu Kuang  1 , Yu-Cai Zhang  2 , Wen-Yan Huang  1 , Guang-Hua Zhu  3
Affiliations
Case Reports

Chylopericardium in a child with IgA nephropathy: a case report

Yu-Lin Kang et al. BMC Pediatr. .

Abstract

Background: Chylopericardium effusion is characterized by the accumulation of milky effusion in the pericardium. It is often idiopathic but it can be secondary to trauma, chest radiation, tuberculosis and malignancy. If cardiac tamponade ensues, it becomes life-threatening. Herein we describe chylopericardium tamponade in a child with IgA nephropathy. To the best of our knowledge, this is the first reported case of chylopericardium tamponade in IgA nephropathy.

Case presentation: A 6 years old boy with IgA nephropathy presented with dyspnea, orthopnea, pretibial pitting edema, ascites and fever. Muffled heart sounds and hepatomegaly were also noted. Echocardiography and thoracic CT revealed that there was a large volume of hydropericardium. Moreover, the pericardial milky fluid by pericardiocentesis was analyzed and chylopericardium effusion was eventually confirmed. Pericardial drainage was continued and his diet was modified to low fat, rich MCT and high protein. Complete remission was achieved after 3 weeks of this combined treatment.

Conclusion: Chylopericardial tamponade could be a rare and life-threatening complication of IgA nephropathy. Etiological analysis is critical for determining the therapeutic approach in patients with pericardial effusion.

Keywords: Chylopericardium tamponade; IgA nephropathy; Middle chain triglyceride; Pericardiocentesis; Pericardium drainage.

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Conflict of interest statement

Ethics approval and consent to participate

All examinations and investigations in this case were approved by the Ethical Committee of Shanghai Children’s Hospital (China) and were conducted in accordance with the Declaration of Helsinki.

Consent for publication

Written informed consent was obtained from the parents for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor of BMC Pediatrics.

Competing interests

The authors declare that they have no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
a Thoracic CT demonstrating massive pericardial and pleural effusion. b The milky pericardial effusion was obtained from the child with IgA nephropathy. Laboratory tests revealed that this milky pericardial fluid was saturated chylous effusion. c The thoracic CT demonstrating resolution of pericardial effusion after pericardial drainage and modified diet therapy
See this image and copyright information in PMC

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