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A Case of Successful Management of Sarcoidosis with Chylothorax Using Octreotide  

Jung, Kyung Soo (Department of Internal Medicine, Yonsei University College of Medicine)
Moon, Ji Ae (Department of Internal Medicine, Yonsei University College of Medicine)
Yoon, Sul hee (Department of Internal Medicine, Yonsei University College of Medicine)
Byun, Min Kwang (Department of Internal Medicine, Yonsei University College of Medicine)
Jung, Woo Young (Department of Internal Medicine, Yonsei University College of Medicine)
Jung, Jae Hee (Department of Internal Medicine, Yonsei University College of Medicine)
Choi, Sang Bong (Department of Internal Medicine, Yonsei University College of Medicine)
Kim, Dae Joon (Department of Cardiovascular & Thoracic Surgery, Yonsei University College of Medicine)
Pyo, Ju Yeon (Department of Pathology, Yonsei University College of Medicine)
Kim, Young Sam (Department of Internal Medicine, Yonsei University College of Medicine)
Kim, Se Kyu (Department of Internal Medicine, Yonsei University College of Medicine)
Chang, Joon (Department of Internal Medicine, Yonsei University College of Medicine)
Kim, Sung Kyu (Department of Internal Medicine, Yonsei University College of Medicine)
Park, Moo Suk (Department of Internal Medicine, Yonsei University College of Medicine)
Publication Information
Tuberculosis and Respiratory Diseases / v.62, no.2, 2007 , pp. 119-124 More about this Journal
Abstract
Sarcoidosis is a multi-system granulomatous disorder of an unknown etiology and affects individuals worldwide. It is characterized pathologically by the presence of non-caseating granulomas in more than one involved organ. However, pleural involvement of sarcoidosis is rare and there are no reported cases in Korea. Traditionally, sarcoidosis has often been treated with systemic corticosteroids or cytotoxic agents. In particular, chylothorax with sarcoidosis is usually treated with corticosteroid for approximately 3~6 months, followed by repeated therapeutic thoracentesis, talc pleurodesis, dietary treatment, or thoracic duct ligation where needed. We encountered a 46 years old female patient presenting with cough, dyspnea and both hilar lymphadenopathy (stage I) on chest radiograph. The patient was diagnosed with a non-caseating granuloma, sarcoidosis by a mediastinoscopic biopsy. For one month, she had suffered from dyspnea due to right side pleural effusion, which was clearly identified as a chylothorax on thoracentesis. Corticosteroid therapy with dietary adjustment was ineffective. She was treated successfully with a subcutaneous injection of octreotide for 3 weeks and oral corticosteroid. We report a case of successful and rapid treatment of chylothorax associated with sarcoidosis using octreotide and oral corticosteroid.
Keywords
Sarcoidosis; Chylothorax; Pleural involvement; Octreotide; Mediastinoscopy;
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