Management of hemorrhagic pleural effusion with intrapleural streptokinase in a patient on peritoneal dialysis and dual antiplatelet therapy.
Abhisek ThapaliyaUrza BhattaraiArun GautamDeepak DhakalBhupendra ShahSanjib K SharmaPublished in: Clinical case reports (2023)
Pleural effusion is seen in up to 10 percent of patients on peritoneal dialysis (PD). A hemorrhagic pleural effusion is a diagnostic dilemma and a therapeutic challenge. We report a complicated case of 67 years old man with end stage renal disease, with coronary artery disease and stent in situ under dual antiplatelet therapy and continuous ambulatory peritoneal dialysis. The patient presented with left-sided loculated hemorrhagic pleural effusion. He was managed with intrapleural streptokinase therapy. His loculated effusion resolved without any local and systemic bleeding manifestations. Therefore, in poor resource settings, Intrapleural streptokinase can be an option for loculated hemorrhagic pleural effusion among patients receiving CAPD and under DAPT. Its use can be individualized based on risk benefit analysis by the treating clinician.
Keyphrases
- end stage renal disease
- peritoneal dialysis
- antiplatelet therapy
- percutaneous coronary intervention
- acute coronary syndrome
- coronary artery disease
- chronic kidney disease
- case report
- coronary artery bypass grafting
- blood pressure
- atrial fibrillation
- type diabetes
- cardiovascular events
- bone marrow
- stem cells
- cell therapy