Late-onset lymphedema has been associated with pleural effusions.1-4 We describe a patient with generalized late-onset lymphedema, bilateral pleural effusions, and the previously unreported finding of pericardial effusion resulting in cardiac tamponade.
Report of a Case.—A 12-year-old girl was referred with the chief complaint of morning perioral and periorbital edema of one year's duration and the recent onset of suprapubic "fullness" of the skin. At that time, values for complete blood cell (CBC) count, ESR, total protein, albumin, urinalysis, chest roentgenogram, and intravenous (IV) pyelogram were normal. Fifteen months after the onset of symptoms, she experienced mild pitting edema of the legs and was admitted to the hospital for further evaluation. Medical history and family history were otherwise unremarkable. There was no suggestion of thyroid dysfunction or autoimmune disease.
Physical examination revealed a pubescent, well-developed 12-year-old girl. Her vital signs were normal. There was no lymphadenopathy. The thyroid was