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      Yellow nail syndrome accompanied by minimal-change nephrotic syndrome: A case report

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          Abstract

          BACKGROUND

          In most cases of yellow nail syndrome (YNS), the classic triad of yellow nails, lymphedema and respiratory manifestations rarely manifest simultaneously. Therefore, diagnosis is delayed or frequently missed.

          CASE SUMMARY

          We report a 62-year-old YNS patient presenting with bilateral pleural, pericardial and peritoneal effusions who, 2 mo later, developed minimal-change nephrotic syndrome. After treatment with vitamin E, clarithromycin and prednisone for 3 mo, effusions in the chest, pericardium and abdominal cavity decreased while urine protein levels returned to within normal ranges.

          CONCLUSION

          Clinicians should consider the possibility of YNS for patients presenting with multiple serous effusions and nephrotic syndromes.

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          Most cited references23

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          Yellow nails, lymphoedema, and pleural effusions.

          Charles P Emerson (1966)
          Article 0 comments Cited 28 times – based on 0 reviews     Review now
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            Yellow nail syndrome: a review

            Stéphane Vignes, Robert Baran (2017)
            Yellow nail syndrome (YNS; OMIM 153300, ORPHA662) is a very rare disorder that almost always occurs after 50 years of age but a juvenile or familial form has also been observed. YNS is diagnosed based on a triad associating yellow nail discoloration, pulmonary manifestations (chronic cough, bronchiectasia, pleural effusion) and lower limb lymphedema. Chronic sinusitis is frequently associated with the triad. YNS etiology remains unknown but a role of lymphatic impairment is usually evoked. YNS is more frequently isolated but may be associated in rare cases with autoimmune diseases, other clinical manifestations implicating lymphatic functions or cancer and, hence, is also considered a paraneoplastic syndrome. YNS management is symptomatic and not codified. YNS can resolve spontaneously. Oral vitamin E alone or even better when associated with triazole antifungals may achieve partial or total disappearance of nail discoloration. Pleural effusion can be treated surgically, with decortication/pleurectomy or pleurodesis. Antibiotic prophylaxis is prescribed for bronchiectasia with chronic sputum production. Lymphedema treatment is based on low-stretch bandages and the wearing of elastic compression garments combined with skin care, exercises and, as needed, manual lymph drainage.
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              Yellow nail syndrome.

              Jay H Ryu, Fabien Maldonado (2009)
              The yellow nail syndrome (YNS) is a rare disorder of unknown cause characterized by the triad of yellow and thickened nails, lymphedema and respiratory manifestations. We review the current state of knowledge, particularly regarding the diagnosis and management of this disorder. Available data suggest acquired lymphatic dysfunction to be the predominant mechanism underlying the clinical manifestations of YNS. The clinical features are variable among individuals diagnosed to have this disorder, and these features can vary over time. Although many disorders have been reported to be associated with YNS, there is no consistent theme in these associations. Longevity of patients with YNS is modestly reduced when compared with a control population. There is no specific treatment for YNS, but most patients can be managed with supportive measures aimed at ameliorating various clinical manifestations. The pathogenesis of YNS remains poorly defined. The diagnosis is established on the basis of characteristic clinical features including abnormal nails, lymphedema and respiratory manifestations. The clinical course is generally benign, and current treatment aims to control the various clinical manifestations of this obscure disease process.
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                Author and article information

                Contributors
                Ya-Nan Zhang
                Mei-Hua Wang
                Wen-Cheng Yu
                Wei Cheng
                Jin-Peng Cong
                Xue-Peng Huang
                Fang-Fang Wang
                Journal
                Journal ID (nlm-ta): World J Clin Cases
                Journal ID (publisher-id): WJCC
                Title: World Journal of Clinical Cases
                Publisher: Baishideng Publishing Group Inc
                ISSN (Electronic): 2307-8960
                Publication date (Print): 26 May 2022
                Publication date (Electronic): 26 May 2022
                Volume: 10
                Issue: 15
                Pages: 4949-4956
                Affiliations
                Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
                Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
                Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
                Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
                Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
                Department of Respiratory and Critical Care Medicine, People's Hospital of Rizhao Lanshan, Rizhao 276800, Shandong Province, China
                Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China. yaorao1984@ 123456163.com
                Author notes

                Author contributions: Cheng W and Wang MH analyzed and interpreted the patient data regarding the disease; Cong JP and Wang MH performed the histological examination of the pleura and pleural effusion; Huang XP performed the histological examination of kidney; Zhang YN and Wang FF was major contributors in writing the manuscript; Yu WC reviewed and corrected the manuscript; all authors issued final approval for the version to be submitted.

                Corresponding author: Fang-Fang Wang, Doctor, MD, Attending Doctor, Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao 266000, Shandong Province, China. yaorao1984@ 123456163.com

                Article
                Other ID: jWJCC.v10.i15.pg4949
                DOI: 10.12998/wjcc.v10.i15.4949
                PMC ID: 9198869
                SO-VID: 4dafaf03-ba7a-44a4-a395-ffdfb56260d8
                Copyright © ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
                License:

                This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

                History
                Date received : 13 October 2021
                Date revision received : 27 December 2021
                Date accepted : 3 April 2022
                Categories
                Subject: Case Report

                Keywords: yellow nail syndrome,pleural effusion,pericardial effusion,peritoneal effusion,nephrotic syndrome,case report
                Data availability:
                Keywords: yellow nail syndrome, pleural effusion, pericardial effusion, peritoneal effusion, nephrotic syndrome, case report

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