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Successful treatment of a complex malignant pleural effusion with 1 mg alteplase instilled through a non-draining indwelling pleural catheter
  1. Nik Nuratiqah Nik Abeed,
  2. Mohamed Faisal,
  3. Boon Hau Ng and
  4. Andrea Ban Yu-Lin
  1. Respiratory Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  1. Correspondence to Dr Mohamed Faisal; arabinose{at}


Indwelling pleural catheter (IPC) is the treatment of choice in managing symptomatic recurrent malignant pleural effusion (MPE). Loculated effusions following insertion may occur due to infection, catheter malfunction or the inflammatory nature of MPE. Loculations may lead to ineffective drainage and make the IPC non-functional. We report a 56-year-old man with symptomatic loculated malignant pleural effusion with an IPC, successfully drained with a single dose of 1 mg recombinant tissue plasminogen activator alteplase. This is the lowest dose currently applied in our centre for efficient drainage and improvement of dyspnoea.

  • lung cancer (oncology)
  • respiratory cancer
  • empyema

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  • Contributors Conceptualisation: NNNA and MF. Writing: NNNA, BHN, and ABY-L Investigation: BHN. Supervisor: AB-YL and MF.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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