J Bras Pneumol.2005;31(6):567-9 Diagnosis of the case presented in the previous edition

A 66-year-old patient with a history of chronic lymphedema of the lower extremities, accompanied by recurrent pneumonia and pleural effusion. Presenting chronic cough with sputum that is colorless but abundant in the mornings. COMMENTS Yellow nail syndrome is a rare disorder characterized by a combination of lymphedema of the lower limbs (in 80 % of cases), recurrent pneumonia, bronchiectasis, pleural (sometimes chylous) effusion (in 36%) and yellowing of the fingernails (in 89%). The etiology of the disease is unknown, and familial occurrence is rare. It is believed that the lymphedema, as well as the discoloration of the nails and the pleural effusion, are secondary to flaws in the development of the lymphatic canals (hypoplasia and dilatation). Bronchiectasis is more common in the lower lung lobes and might be accompanied by mucoid impaction (as in the case illustrated here). Its etiology is likely related to recurrent infection. DANY JASINOWODOLINSKI; GILBERTO SZARF