Post-traumatic pleural effusion: Don't forget the chylothorax!

In this case we describe a 58-year-old male with bilateral pleural effusion after a blunt trauma to the back. A pleural puncture revealed a chylothorax. An additional computed tomography scan showed a vertebral fracture at level D8 with rupture of the nearby thoracic duct. Our patient could be treated with a conservative approach. This case highlights the importance of ruling out a chylothorax in any post-traumatic pleural effusion. Despite the low prevalence, we consider it a don't-miss diagnosis given the specific treatment requirements.

Severe Hypertriglyceridemia After Use of Bempedoic Acid.

Bempedoic is a new drug for the management of hypercholesterolemia, approved since 2020 by the EMA for use in Europe. In this case report, we describe a 65-year-old woman with sudden worsening of hypertriglyceridemia after the introduction of bempedoic acid. Triglyceride levels normalized quickly on withdrawal of the drug. With this case report, we want to reveal a possible association between bempedoic acid and the paradoxical occurrence of hypertriglyceridemia. Furthermore, we want to emphasize the limited evidence regarding the use of bempedoic acid in patients with pre-existing hypertriglyceridemia. LEARNING POINTS: Bempedoic acid is a new drug with a proven positive effect on LDL reduction and cardiovascular outcomes.Metabolic adverse events, especially hyperuricemia and gout, following the use of bempedoic acid are well documented.The current literature provides very limited evidence regarding the use of bempedoic acid in patients with pre-existing hypertriglyceridemia, so caution is advised regarding use of this drug this population.