Long-term follow-up of children with congenital chylothorax

Abstract

To the Editors: Congenital chylothorax, defined as the accumulation of lymphatic fluid in the pleural cavity, is a rare neonatal disorder. Nevertheless, congenital chylothorax represents the most common cause of pleural effusion in fetuses and newborns [1]. Due to the rarity of this disorder only a few case series are reported in the literature and current treatment recommendations are based on individual case reports or case series only [2–5]. The diagnosis of chylothorax is considered when pleural fluid triglyceride levels are >1.1 mmol·L−1 and total cell counts are >1,000 cells per mL with >80% lymphocytes. Without oral fat intake chylomicrons, which are often an indication for the diagnosis of chylothorax, are absent in the pleural fluid and distinction between chylous and non-chylous effusion might be difficult [6]. Long-term follow-up of children with congenital chylothorax, however, was documented in only four studies [7–10] and none included pulmonary function testing. We describe the clinical course and long-term outcome of infants with congenital chylothorax including neurodevelopmental follow-up and pulmonary function testing. In this study the data of all children who were documented in the local database of the Division of Neonatology (Paediatric Dept, Medical University of Graz, Graz, Austria) with the diagnosis of congenital chylothorax between January 1, 1995 and December …