Nail sample

Nail sample


For several weeks, the woman suffers from cough. As you developed, in addition a fever before you get in the ambulance, the Honjo-Daiichi hospital in Japan Yurihonjo.

The Doctors the lung of the 78 listen to-Year-olds: it rattles when Breathing. In your blood, too little oxygen is present. An x-Ray shows that has collected in the area between the lungs and the Ribs, the so-called pleural cavity, fluid. Doctors call this phenomenon, pleural effusion. It explains the persistent coughing of the patient. A pleural effusion can cause shortness of breath and the oxygen supply to affect.

Signs of a heart attack not discover the Doctors at the woman.

On the radiograph, a double-sided pleural effusion is seen

Bacteria, Cancer, Inflammation?

The doctors begin to look for the cause of the pleural effusion. Here, there are a number of possible explanations.

  • By using a computer tomography of the upper part of the body, they conclude that a Tumor is present.
  • The doctors remove a sample of fluid to see whether bacteria are present. This is not the case. So there is no bacterial infection behind the complaints.
  • A blood test indicates inflammation. The woman may have rheumatoid Arthritis? The disease primarily affects the joints, it can also damage the lungs. More accurate Tests do not confirm this suspicion, however.

Two Details of the Doctors, Both the finger nails and the toe nails of the 78-Year-old discolored yellow. In addition, their feet are due to an accumulation of fluid, lymphedema, swollen. This reveals the diagnosis?

The finger nails are discolored yellow

The Doctors, Hideya Itagaki and Suzuki, Katuhiko, deal with the medical history of the patient, as they report in the “Journal of Medical Case Reports”. The woman had to undergo various surgeries to the knees, and the spine and carries since then implants in the body. The most recent SURGERY on the spine is a quarter of a year. On an x-ray image of your chest, that arose prior to this engagement, is to detect a pleural effusion to.

Very rare disease

All of this information lead Doctors to the diagnosis: The woman has the so-called Yellow nails syndrome.

This extremely rare disease has three typical symptoms:

  • The yellow discolored nails. These are usually thickened, and grow only slowly.
  • Persistent respiratory problems such as chronic cough or pleural effusions.
  • Lymph edema, i.e. excessive accumulation of fluid.

What are the exact processes in the body lead to this combination of symptoms is not yet explored. It is believed that a disturbance of the lymph flow plays a role. The lymph, a milky aqueous liquid, flowing in a vascular system by the body and is, among other things, for the drainage of tissue responsible. Due to some of the described cases it is assumed that, among other things, titanium implants able to trigger the Yellow nails syndrome.

The patient in Japan, the Doctors observe all the typical symptoms of the syndrome. In addition, the symptoms began a month after the SURGERY, the woman received a titanium-containing implant.

To remove, this is for the patient not a good Option. Because it sits on the spine and supports it (see x-ray image above). In principle, such a SURGERY can be Affected with Yellow nails syndrome of a solution.

The wife receives, instead, Vitamin-E-tablets to normalize the growth of your fingernails and toenails again. After about half a year has improved the condition of the nails significantly.

Against the pleural effusion, the Vitamin supplementation does not help, however. The Doctors sticking a cave in a OP the pleura, which should actually result in no more liquid can penetrate into this small space between the lungs and Ribs. But, unfortunately, the intervention brings no improvement.

Therefore, the woman is now about every one to two months in the hospital and the Doctors to produce an x-Ray of your chest. Has collected in the pleural cavity too much fluid, it is filtered off with suction.