Moffitt Report 5/23: Chylothorax and Mucocutaneous Lupus

Two great cases today: one about chylothorax and one about mucocutaneous lupus which got us thinking about abdominal manifestations of lupus!

Chylothorax (TG >110mg/dL, usually exudative, can become lymphopenic and malnourished!)

  • Trauma
    • Surgical and procedural (including central lines)
    • Nonsurgical: penetrating or non-penetrating trauma to the neck/thorax/upper abdomen, but can even happen with vomiting, coughing
  • Non-traumatic: think about obstruction
    • Malignant neoplasm (most common!): lymphoma mostly, also primary lung, mediastinal tumors
    • Non-malignant: long list involving thing’s that can cause obstruction of the normal lymphatic flow (LAM, granulomatous infections, subclavian thrombus, SVC syndrome)

 

Abdominal manifestations of lupus

  • Intestinal pseudo-obstruction
  • Autoimmune hepatitis
  • Acute pancreatitis
  • Mesenteric vasculitis
  • Peritonitis (less common than pleural or pericardial involvement)
  • Protein losing enteropathy
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