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A case of bilateral cholesterol pleurisy associated with heart failure analysis of lipoprotein and apoprotein in pleural effusion

A case of bilateral cholesterol pleurisy associated with heart failure analysis of lipoprotein and apoprotein in pleural effusion

Japanese Journal of Chest Diseases 48(11): 935-940

A 58 year-old male was admitted to our hospital because of dyspnea on exertion and peripheral edema. Six years ago, he suffered from tuberculous pleuritis. Cardiomegaly and bilateral pleural effusion were found on chest X-ray film. He was diagnosed as heart failure, which improved by administration of digitalis and diuretics. However, pleural effusion persisted in the bilateral pleural cavities. By aspiration of bilateral pleural effusion, turbid and yellow pleural effusion was obtained. Cholesterol crystals were observed in bilateral effusion on microscope. More cholesterol crystals was noted in the right effusion than in the left effusion. He was diagnosed as bilateral cholesterol pleurisy, a rarely reported disorder. An analysis of lipids, lipoproteins and apoproteins in serum and in bilateral pleural effusion revealed that total cholesterol, .beta.-LP and LDL levels in right effusion were higher than serum levels. However, these levels in left effusion were lower than in serum levels. LDL/ApoB ratios in right and left effusion were higher than that in serum. Thus it was presumed that the formation of cholesterol crystals in the pleural avity was related to the LDL/ApoB ratio.

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Accession: 006932103

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