(HealthDay)—In a case report published online Dec. 7 in Pediatrics, yellow nail syndrome (YNS) is described in a 9-year-old girl who had titanium detected in her nail clippings.

Ting-Yuan Hsu, M.D., from the MacKay Children's Hospital in Taipei, Taiwan, and colleagues present the case of a 9-year-old girl with yellowish nail discoloration for one year, who also reported respiratory symptoms, including , recurrent pneumonia, bronchiectasis, and .

The researchers diagnosed the patient with YNS. Her nail clippings were collected and was detected in them using energy dispersive radiograph fluorescence. Titanium exposure may have resulted from swallowing children's toothpaste. Amelioration was reported in yellow nail discoloration, as well as diminution of , with meticulous avoidance of toothpaste swallowing. No titanium was detected on reevaluation of her nail clippings three years later.

"This observation suggests that avoiding titanium exposure could alleviate the symptoms of YNS," the authors write. "This is the first report of YNS in a pediatric patient that demonstrates a relationship between YNS and titanium."

Garefully Technology Co. assisted with analysis of the nail sample.