Yellow nail syndrome: does protein leakage play a role?

Yellow nail syndrome is characterized by primary lymphoedema, recurrent ple ural effusion and yellow discoloration of the nails. Although mechanical ly mphatic obstruction is assumed to be the underlying pathology, it cannot ex plain the common finding of high albumin concentration in the pleural space . This paper describes a case of yellow nail syndrome presenting with the c lassical triad of lymphoedema, recurrent pleural effusion and yellow discol oration of the nails, associated with persistent hypoalbuminaemia and incre ased enteric loss of albumin. Based on the findings in this case and those in the literature, it is speculated that increased microvascular permeabili ty may contribute to the pathogenesis of this syndrome.