Recurrent Pleural Transudate in the Nephrotic Syndrome

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Abstract
PLEURAL transudates are a common feature of salt-retaining conditions. Little has been written, however, about the therapy for intractable or recurrent extensive pleural transudates. We report a case successfully treated by tetracyclineinduced pleural symphysis. Report of a Case A 70-year-old white woman was admitted to the University of Wisconsin Hospital in May 1971 for evaluation of the nephrotic syndrome and rapidly progressing renal failure. She was normotensive, weighed 110 kg (224 lb), and had pretibial edema (4+ ). The serum creatinine level was 10.1 mg/100 ml, and the serum albumin level was 1.8 gm/100 ml. Creatinine clearance was 6 ml/min, and protein excretion was 8 gm/day. Test for antinuclear antibody was negative. A chest x-ray film showed cardiomegaly with bilateral pleural effusions. A renal biopsy specimen disclosed sclerosis of 8 of 26 glomeruli seen with mesangial hypercellularity and widening in the others. Hemodialysis was begun, and the patient rapidly lost 13

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