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An unusual cause of pleural effusion
  1. A Reghukumar,
  2. V Chandran,
  3. J M Pappachan,
  4. J Antony,
  5. K Vijayakumar
  1. Department of Medicine, Kottayam Medical College, South India
  1. Correspondence to:
 Dr M J Pappachan
 Department of Medicine, Kottayam Medical College, South India 686008; drpappachan{at}yahoo.co.in

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A 72 year old man with 30 years history of type 2 diabetes mellitus who had been taking insulin for the previous 12 years was brought to the emergency department with breathlessness and lethargy of two days duration. He had diarrhoea and abdominal pain for three weeks and productive cough for one week and had omitted insulin for one week because of tiredness.

On admission he was afebrile with a pulse rate of 120 …

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