A 69 year old male presented with one month of general weakness and progressive shortness of breath. Workup revealed a large unknown pleural effusion, and he was admitted to our hospital for investigation. Medical history included kidney transplantation 11 years prior to his admission, due to end stage renal disease secondary to type 2 diabetes mellitus, diabetic retinopathy and neuropathy, hypertension, ischemic heart disease, CVA and fixation of the cervical spine 15 years ago. His kidney function gradually declined due to uncontrolled diabetes mellitus and chronic rejection, reaching advanced renal failure.
