Bilateral pleural decortication in a child after steroid resistant nephrotic syndrome

Pachypleuritis is a rare complication of pleural effusion due to nephrotic syndrome. The causes of pachypleuritis vary widely and the impact on respir atory function can be extraordinarily severe. A case is reported in an 11-y ear-old girl with steroid resistant nephrotic syndrome and diffuse mesangia l proliferation on the renal biopsy. She had chronic bilateral pleural exud ates, which became increasingly abundant despite hemodialysis and ultrafilt ration. Pachypleuritis with adhesions developed, causing a severe restricti ve defect in ventilation. Bilateral pleural decortication was performed. Th e clinical and functional outcomes were favorable. Pleural decortication is effective in the exceedingly rare event of pachypleuritis complicating nep hrotic syndrome.