Recurrent symptomatic pleural effusion from a syringopleural shunt

A patient with a syringopleural shunt with dyspnea and cough was found to have a recurrent large pleural effusion. Computed tomography of the thorax revealed the syringopleural shunt catheter abutting the pleural effusion, and beta-2 transferrin was detected in the pleural fluid, suggesting that the recurrent symptomatic pleural effusion was secondary to the syringopleural shunt. Physicians should be cognizant of this potential long-term complication of syringopleural shunts. Management includes revising the shunt with a programmable device or converting it to a syringoperitoneal or syringoarachnoid shunt.