Key result
Thyroid hormone improves pericardial and pleural effusions in a yellow nail syndrome case with hypothyroidism.
Why the study?
Pericardial effusion is a rare manifestation of yellow nail syndrome with limited guidance on management.
Case Report (n=1)
Treatment of concomitant hypothyroidism in a patient with Yellow Nail Syndrome led to improvement of a chronic large pericardial effusion, suggesting a shared pathophysiological pathway.
May warrant hypothyroidism screening in YNS with effusions; leaves open need for prospective confirmation.
BACKGROUND: Yellow nail syndrome (YNS) is a rare disorder characterized by the triad of yellow nails, lymphedema, and respiratory manifestations. Rarely, pericardial effusion can occur and guidance on management is limited. CASE SUMMARY: A 71-year-old man presented with chronic large pericardial and pleural effusions, lower extremity lymphedema, and yellow nail discoloration. He was diagnosed with YNS, and several years later hypothyroidism was identified. Treatment with thyroid hormone led to improvement in his pericardial effusion and stabilization of pleural effusions. DISCUSSION: Pericardial involvement in YNS is rare, but can manifest as large effusions. In such cases, it is important to exclude concomitant reversible conditions such as hypothyroidism or autoimmune disease. This case suggests a common pathway between hypothyroidism and YNS pathophysiology with improvement after treatment, but not complete resolution. Chronic, large pericardial effusions in hemodynamically stable patients can safely be monitored with surveillance.
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Canova et al. (2025) conducted a case report in Yellow nail syndrome with chronic large pericardial effusion and hypothyroidism (n=1). Thyroid hormone was evaluated on Improvement in pericardial effusion and stabilization of pleural effusions. Treatment with thyroid hormone led to improvement in pericardial effusion and stabilization of pleural effusions in a 71-year-old man with yellow nail syndrome and hypothyroidism.
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