{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T14:26:28Z","timestamp":1760711188092,"version":"3.41.2"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T00:00:00Z","timestamp":1686268800000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec><jats:title>Key Clinical Message<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p>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\u2009years 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\u2010sided 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.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccr3.7517","type":"journal-article","created":{"date-parts":[[2023,6,10]],"date-time":"2023-06-10T04:14:20Z","timestamp":1686370460000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Management of hemorrhagic pleural effusion with intrapleural streptokinase in a patient on peritoneal dialysis and dual antiplatelet therapy"],"prefix":"10.1002","volume":"11","author":[{"given":"Abhisek","family":"Thapaliya","sequence":"first","affiliation":[{"name":"Department of Internal Medicine B.P Koirala Institute of Health Sciences  Dharan Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5895-1405","authenticated-orcid":false,"given":"Urza","family":"Bhattarai","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B.P Koirala Institute of Health Sciences  Dharan Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5588-4902","authenticated-orcid":false,"given":"Arun","family":"Gautam","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B.P Koirala Institute of Health Sciences  Dharan Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepak","family":"Dhakal","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B.P Koirala Institute of Health Sciences  Dharan Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhupendra","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B.P Koirala Institute of Health Sciences  Dharan Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjib K.","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B.P Koirala Institute of Health Sciences  Dharan Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,6,9]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3747\/pdi.2008.00168"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.4061\/2011\/526753"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.disamonth.2018.09.002"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2010.08.006"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-0725"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2021.106706"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2020.11.005"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa042473"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.5144\/0256-4947.2006.145"},{"key":"e_1_2_11_11_1","first-page":"889","volume-title":"Transplantation Proceedings","author":"Bakirci T","year":"2007"},{"volume-title":"Fellows' Forum in Dialysis Edited by Mark A. 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