{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T21:03:40Z","timestamp":1765487020124,"version":"3.40.5"},"reference-count":20,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T00:00:00Z","timestamp":1703203200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>SARS-CoV-2 is a novel coronavirus that has rarely been associated with chylothorax. Patients with Noonan syndrome are at risk for developing chylothorax, especially after cardiothoracic interventions. We present the case of SARS-CoV-2 infection triggering the underlying tendency of a patient with Noonan syndrome to develop chylothorax who did not develop it even after prior cardiothoracic interventions. Patient presented in respiratory distress without hypoxia and was found, on imaging, to have a large right-sided pleural effusion, which was eventually classified as chylothorax. The patient was then started on a low-fat diet. Chest tube drainage substantially reduced the effusion in size, and it remained stable. Our report highlights that SARS-CoV-2 infection can cause the development of a chylothorax or a chylous effusion in patients with Noonan syndrome or among populations with a similar predisposition. A high index of suspicion in vulnerable patients or those not responding to traditional therapy should exist with providers, thus leading to the testing of the fluid to confirm the diagnosis.<\/jats:p>","DOI":"10.1017\/s1047951123004171","type":"journal-article","created":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T09:20:05Z","timestamp":1703236805000},"page":"448-451","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Chylothorax related to acute SARS-CoV-2 infection in a patient with Noonan syndrome with prior uncomplicated cardiac surgeries"],"prefix":"10.1017","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6307-2106","authenticated-orcid":false,"given":"Lubaina","family":"Ehsan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica A.","family":"Thoe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John J.","family":"Parent","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph D.","family":"Fakhoury","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2023,12,22]]},"reference":[{"key":"S1047951123004171_ref11","doi-asserted-by":"crossref","first-page":"507","DOI":"10.7326\/0003-4819-77-4-507","article-title":"Pleural effusions: the diagnostic separation of transudates and exudates","volume":"77","author":"Light","year":"1972","journal-title":"Ann Intern Med"},{"key":"S1047951123004171_ref15","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1111\/j.1442-200X.1996.tb03733.x","article-title":"Congenital chylothorax in a patient with 21 trisomy syndrome","volume":"38","author":"Yamamoto","year":"1996","journal-title":"Pediatr Int"},{"key":"S1047951123004171_ref7","first-page":"271","article-title":"Lymphatic abnormalities in Noonan syndrome: a case report","volume":"56","author":"Smith","year":"1979","journal-title":"S Afr Med J"},{"key":"S1047951123004171_ref17","doi-asserted-by":"crossref","first-page":"11164","DOI":"10.1038\/s41598-022-13806-w","article-title":"MR lymphangiography of lymphatic abnormalities in children and adults with Noonan syndrome","volume":"12","author":"Pieper","year":"2022","journal-title":"Sci Rep-UK"},{"key":"S1047951123004171_ref19","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.jpeds.2022.05.030","article-title":"Trametinib for refractory chylous effusions and systemic complications in children with Noonan syndrome","volume":"248","author":"Nakano","year":"2022","journal-title":"J Pediatr"},{"key":"S1047951123004171_ref12","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1097\/00008480-200010000-00017","article-title":"Congenital chylothorax","volume":"12","author":"Dubin","year":"2000","journal-title":"Curr Opin Pediatr"},{"key":"S1047951123004171_ref18","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1542\/peds.2020-0167","article-title":"Severe lymphatic disorder resolved with MEK inhibition in a patient with Noonan syndrome and SOS1 mutation","volume":"146","author":"Dori","year":"2020","journal-title":"Pediatrics"},{"key":"S1047951123004171_ref1","doi-asserted-by":"crossref","first-page":"e0836","DOI":"10.1002\/rcr2.836","article-title":"Chylothorax found in a patient with COVID-19","volume":"10","author":"Satriano","year":"2022","journal-title":"Respirol Case Rep"},{"key":"S1047951123004171_ref16","first-page":"461","article-title":"Impact of Noonan syndrome on admissions for pediatric cardiac surgery","volume":"74","author":"Kriz","year":"2019","journal-title":"Minerva Pediatr"},{"key":"S1047951123004171_ref6","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1002\/pd.1189","article-title":"Prenatal DNA diagnosis of Noonan syndrome in a fetus with massive hygroma colli, pleural effusion and ascites","volume":"25","author":"Schl\u00fcter","year":"2005","journal-title":"Prenat Diagn"},{"key":"S1047951123004171_ref9","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/S0140-6736(12)61023-X","article-title":"Noonan syndrome","volume":"381","author":"Roberts","year":"2013","journal-title":"Lancet"},{"key":"S1047951123004171_ref8","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1007\/BF00441221","article-title":"Spontaneous chylothorax in Noonan\u2019s syndrome","volume":"138","author":"Fisher","year":"1982","journal-title":"Eur J 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Two case reports, including successful treatment by MEK inhibition","volume":"13","author":"Gordon","year":"2022","journal-title":"Front Genet"},{"key":"S1047951123004171_ref2","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1111\/jpc.15574","article-title":"SARS-CoV-2 associated with death in an infant with congenital chylothorax","volume":"58","author":"Bezirganoglu","year":"2022","journal-title":"J Paediatr Child H"},{"key":"S1047951123004171_ref3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.rmed.2009.08.010","article-title":"Chylothorax: aetiology, diagnosis and therapeutic options","volume":"104","author":"McGrath","year":"2010","journal-title":"Resp Med"},{"key":"S1047951123004171_ref14","first-page":"961","article-title":"Spontaneous chylothorax in newborns","volume":"138","author":"Van Aerde","year":"1984","journal-title":"Am J Dis Child"},{"key":"S1047951123004171_ref13","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1111\/j.1651-2227.2006.tb02342.x","article-title":"Pleural effusions in the neonate","volume":"95","author":"Rocha","year":"2006","journal-title":"Acta Paediatr"},{"key":"S1047951123004171_ref5","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1111\/j.1440-1754.1989.tb01481.x","article-title":"Noonan syndrome with spontaneous chylothorax at birth","volume":"25","author":"C.H.A.N.","year":"1989","journal-title":"J Paediatr Child H"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951123004171","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T00:09:58Z","timestamp":1708474198000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951123004171\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,22]]},"references-count":20,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["S1047951123004171"],"URL":"https:\/\/doi.org\/10.1017\/s1047951123004171","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"type":"print","value":"1047-9511"},{"type":"electronic","value":"1467-1107"}],"subject":[],"published":{"date-parts":[[2023,12,22]]},"assertion":[{"value":"\u00a9 The Author(s), 2023. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}