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(Chest. 1972;61:452-458.)
© 1972 American College of Chest Physicians

Pulmonary Manifestations of the Yellow Nail Syndrome

Erhard Hiller M.D.1; Edward C. Rosenow III M.D., F.C.C.P.2; and Arthur M. Olsen M.D., F.C.C.P.2

1 Mayo Graduate School of Medicine (University of Minnesota), Rochester: Resident in Internal Medicine
2 Mayo Graduate School of Medicine (University of Minnesota); Mayor Clinic and Mayo Foundation: Division of Thoracic Diseases and Internal Medicine

The association of primary lymphedema with yellow discoloration of the nails has been termed the "yellow nail syndrome." A third manifestation may be otherwise unexplained pleural effusion. Pulmonary complications are described in 12 patients with various combinations of the yellow nail syndrome. Eight of these patients had recurrent pleural effusions otherwise unexplained. In two patients, surgical procedures were necessary for control of the effusion. Five patients were found to have yellow nails and bronchiectasis, and pleural effusion was present in three of these; five patients had sinusitis. Chronic cough was a persistent finding in all 12 patients. The first manifestation of the yellow nail syndrome was either lymphedema or yellow nails, pleural effusion always appearing later. The time between the development of the various manifestations may vary from several months to many years. The presence of yellow discoloration of the nails is not necessary for a diagnosis; lymphedema and pleural effusion occurring alone or in combination are thought to represent the same syndrome. It may include a propensity toward the development of neoplasms.




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