{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:43:17Z","timestamp":1790739797066,"version":"4.1.0"},"reference-count":9,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,1,27]]},"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:p>Patients with symptomatic complex malignant pleural effusion (MPE) are frequently unfit for decortication and have a poorer prognosis. Septations can develop in MPE, which may lead to failure of complete drainage and pleural infection. Intrapleural fibrinolytic therapy (IPFT) is an alternative treatment. The use of IPFT in patients with anaemia and high risk for intrapleural bleeding is not well established. We report a successful drainage of complex haemoserous MPE with a single modified low-dose of intrapleural 5 mg of alteplase and 5 mg of dornase alfa in a patient with pre-existing anaemia with no significant risk of intrapleural bleeding.<\/jats:p>","DOI":"10.1136\/bcr-2020-239702","type":"journal-article","created":{"date-parts":[[2021,2,5]],"date-time":"2021-02-05T16:07:19Z","timestamp":1612541239000},"page":"e239702","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Successful drainage of complex haemoserous malignant pleural effusion with a single modified low-dose intrapleural alteplase and dornase alfa"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0750-3087","authenticated-orcid":false,"given":"Boon Hau","family":"Ng","sequence":"first","affiliation":[{"name":"Medical Department, Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, Wilayah Persekutuan Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nur Husna","family":"Mohd Aminudin","sequence":"additional","affiliation":[{"name":"Pulmonology, Hospital Serdang, Kajang, Selangor, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona Zaria","family":"Nasaruddin","sequence":"additional","affiliation":[{"name":"Pulmonology, Hospital Serdang, Kajang, Selangor, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamalul Azizi","family":"Abdul Rahaman","sequence":"additional","affiliation":[{"name":"Pulmonology, Hospital Serdang, Kajang, Selangor, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,2,5]]},"reference":[{"key":"2025082801304139000_14.2.e239702.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1012740"},{"key":"2025082801304139000_14.2.e239702.2","doi-asserted-by":"crossref","unstructured":"Mishra EK , Clive AO , Wills GH , et al . 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