Heilkenni gulra nagla

Abstract

We describe a 77 year old man with a prior history of recurrent airway infections, who presented with a history of cough, dyspnea and increased mucous production that had lasted several months. On chest X-ray a pleural effusion was observed. Subsequent thoracocentesis demonstrated an exudate with predominant eosinophils. An infectious cause was ruled out. The pleural effusion subsequently recurred and he was admitted for pleural biopsy, which revealed chronic pleuritis. On physical examination yellow nails on fingers and toes were noted. Subsequently, after exclusion of other diseases, a diagnosis of yellow nails syndrome was established. He was treated with corticosteroids, which were tapered over 6 months. One year later the eosinophilia had subsided, however the pleural effusion remained, although on a much smaller scale.

Heilkenni gulra nagla er afar sjaldgæft en einkennist af gulum nöglum, öndunarfæraeinkennum og bjúg. Orsakir eru ekki að fullu kunnar en taldar eiga sér uppsprettu í vanstarfsemi sogæðakerfis. Lýst er 77 ára gömlum manni með endurteknar öndunarfærasýkingar sem leitaði á bráðadeild með nokkurra mánaða sögu um hósta, uppgang, vaxandi mæði og reyndist vera með fleiðruvökva á lungnamynd. Fleiðruholsástunga og fleiðrusýnistaka leiddi í ljós eosinophiliu og bólgu án skýringa. Við líkamsskoðun reyndist hann vera með gular neglur á fingrum og tám og var hann eftir útilokun annarra sjúkdóma greindur með heilkenni gulra nagla. Hann var meðhöndlaður með sterum og minnkuðu einkenni við það en hurfu þó ekki að fullu.