Propranolol: A novel therapy for neonatal chylothorax secondary to congenital lymphatic anomaly
Bibliographic record
Abstract
Introduction: Neonatal chylothorax, a common cause of pleural effusion in neonates, can occur secondary to trauma or from primary congenital causes. Congenital chylothorax due to chromosomal anomalies or lymphatic malformations can result in refractory chylothorax. Medical management using octreotide, sildenafil, and sirolimus has shown variable success, particularly with congenital chylothorax. These pharmacotherapeutic options have different adverse effect profiles that must be balanced against their effectiveness. Case Presentation: A late preterm infant was born to a consanguineous couple with antenatal suspicion of bilateral pleural effusion. After birth, the infant experienced respiratory distress, and bilateral chest tubes were placed, which drained significant amounts of chylous effusion over the subsequent 4 weeks. Whole genome sequencing revealed a PIEZO-1 mutation associated with congenital lymphatic anomaly. Conventional medical management, including intercostal drainage, medium-chain triglyceride-enriched formula, parenteral nutrition, prednisolone, and octreotide, was continued for an 8-week period without resolution. Propranolol was then initiated, leading to complete resolution of chylothorax. The infant was discharged home on propranolol with no recurrence noted on follow-up. Conclusion: This case report indicates that propranolol can be used as an effective therapy to treat moderate to severe chylothorax, especially in the context of congenital lymphatic anomaly, mainly because of its anti-vascular endothelial growth factor action.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".