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CASE REPORT
Korean J Pediatr 2012 May;55(5) :177-180.
Published online 2012 May 15.        doi:https://doi.org/10.3345/kjp.2012.55.5.177
Successful pleurodesis with OK-432 (picibanil) in preterm infants with persistent pleural effusion
Jeong Eun Kim (Kim JU)1, Chul Lee (Lee C)1, Kook In Park (Park KI)1, Min Soo Park (Park MS)1, Ran Namgung (Namgung R)1, In Kyu Park (Park IK)2
1Departments of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
2Departments of Thoracic and Cardiovascular Surgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
Corresponding Author: Ran Namgung ,Tel: +82-2-2228-2050, Fax: +82-2-393-9118, Email: ranng@yuhs.ac
Copyright © 2012 by The Korean Pediatric Society
ABSTRACT
OK-432 (picibanil) is an inactivated preparation of Streptococcus pyogenes that causes pleurodesis by inducing a strong inflammatory response. Intrapleural instillation of OK-432 has recently been used to successfully treat neonatal and fetal chylothorax. Here we report a trial of intrapleural instillation of OK-432 in two preterm infants who were born with hydrops fetalis and massive bilateral pleural effusion. Both cases showed persistent pleural effusion, refractory to conservative treatment, up to postnatal days 26 and 46, respectively. An average of 80 to 140 mL of pleural fluid was drained daily. In case 1, the infant was treated with OK-432 during the fetal period at gestation 28 weeks and 4 days of gestation, but showed recurrence of pleural effusion and progressed into hydrops. Within two to three days after OK-432 injection, the amount of pleural fluid drainage was dramatically decreased and there was no reaccumulation. We did not observe any side effects related to OK-432 injection. We suggest that OK-432 should be considered as a therapeutic option in infants who have persistent pleural effusion for more than four weeks, with the expectation of the early removal of the chest tube and a good outcome.
Keywords: OK-432 | Chylothorax | Infant | Premature
 
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