Abstract
Background: Chylous ascites is an uncommon condition characterized by a white, milky-appearing peritoneal fluid, and is related to disruption of the lymphatic system from any cause. There have been very few previous reports of calcium channel blockers (CCBs) as potential causes of chylous ascites, and most of the patients were undergoing peritoneal dialysis. Aims: To review the pathogenesis, clinical manifestations, laboratory examinations, treatment options, and prognosis of patients with CCB-related chylous ascites. Method: A retrospective analysis was conducted for patients with CCB-related chylous ascites from publications in PubMed, EMBASE, and LILACS between January 1993 and December 2018. Results: A total of 48 cases were included. The average age at disease onset was 50.2 ± 10.9 years, with a male:female ratio of 1.5:1.0. The symptoms of abdominal distension/pain and chylous ascites were observed within 48–72 h of drug initiation and disappeared within 24 h of drug withdrawal. Rechallenge was performed in 10 patients, and all (100%) of them showed chylous effluents that disappeared within 24 h after stopping drug treatment. Conclusions: To summarize, CCB-related chylous ascites is formed of white, milky ascites/effluents that appear after administration of CCBs. Physicians must be aware of the possibility of chylous ascites when administering CCBs, particularly in patients with renal function impairment or patients with end-stage renal disease who are undergoing peritoneal dialysis.
Highlights
Chylous ascites, which is defined as the accumulation of triglyceride-rich fluid in the peritoneal cavity, is an uncommon condition characterized by a white, milky-appearing peritoneal fluid and is related to disruption of the lymphatic system from any cause
(4) Increased lymphatic hydrostatic pressure—Basualdo et al proposed that lercanidipine blocks the voltage-gated calcium channels present in lymphatic vessel smooth cells, resulting in a lack of contractility [23]. This interferes with lymphatic drainage, generates vasodilation, increases the hydrostatic pressure in lymph vessels, and causes exudation of lymph through the walls of dilated retroperitoneal vessels [2]. (5) Ethnic background—our study found that 46 of 48 patients with calcium channel blockers (CCBs)-related chylous ascites were Asian and only two were European
CCB-related chylous ascites is defined as white milky ascites/effluents that appear after administration of CCBs
Summary
Chylous ascites, which is defined as the accumulation of triglyceride-rich fluid in the peritoneal cavity, is an uncommon condition characterized by a white, milky-appearing peritoneal fluid and is related to disruption of the lymphatic system from any cause. The aim of this study was to review the literature concerning CCB-related chylous ascites to outline the pathogenesis, clinical manifestations, laboratory examinations, treatment options, and prognosis of this rare disease entity from January 1993 to December 2018. Chylous ascites is an uncommon condition characterized by a white, milky-appearing peritoneal fluid, and is related to disruption of the lymphatic system from any cause. There have been very few previous reports of calcium channel blockers (CCBs) as potential causes of chylous ascites, and most of the patients were undergoing peritoneal dialysis. Aims: To review the pathogenesis, clinical manifestations, laboratory examinations, treatment options, and prognosis of patients with CCB-related chylous ascites. Physicians must be aware of the possibility of chylous ascites when administering CCBs, in patients with renal function impairment or patients with end-stage renal disease who are undergoing peritoneal dialysis
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