Leuprolide acetate treatment of catamenial pneumothorax

Nonsurgical Treatment of a Catamenial Pneumothorax with a Gn-RH Analogue

“…On the other hand, considered as systemic endometriosis, some authors advocate that the present-day treatment should start with an oral contraceptive, a progestagen, testosterone derivative or a Gn-RH hormone analogue [1, 2, 8]. Gn-Rh analogues have shown to be effective in the treatment of endometriosis as a cause of catamenial pneumothorax [1, 2, 9], and our case supports the efficacy of this treatment modality. Gn-RH analogues represent the most definite method available for disrupting ovarian steroidogenesis to induce resolution of endometriosis.…”

Catamenial pneumothorax caused by diaphragmatic endometriosis

“…2 Considered a rare complication of systemic endometriosis, catamenial pneumothorax has been managed with a wide range of treatments ranging from thoracotomy with abrasive or chemical pleurodesis 2 to the present-day treatment with oral contraceptives, progesterone, or gonadotropin-releasing hormone analogs. 3 The causes of catamenial pneumothorax are diverse. Although most episodes are associated with diaphragmatic endometriosis, few have been confirmed in anatomopathologic studies.…”

“…A variety of options for long-term treatment exist, such as oral contraceptives to suspend ovulation, although relapses sometimes occur after this treatment, bilateral oophorectomy, danazol, and in recent years gonadotropin-releasing hormone analogs, which have been shown to give the best long-term results. 3 On the other hand, from the first cases described, surgical treatment involving the creation of a strong pleural symphysis that impedes the recurrence of pneumothorax via a thoracotomy and mechanical or chemical pleural abrasion or pleurectomy have been carried out. 2,4,5 We therefore recommend that after pleural symphysis a therapeutic regimen of gonadotropin-releasing hormone analogs should be implemented 3 to prevent new episodes of pneumothorax, especially in patients who wish to preserve their reproductive potential.…”

“…3 On the other hand, from the first cases described, surgical treatment involving the creation of a strong pleural symphysis that impedes the recurrence of pneumothorax via a thoracotomy and mechanical or chemical pleural abrasion or pleurectomy have been carried out. 2,4,5 We therefore recommend that after pleural symphysis a therapeutic regimen of gonadotropin-releasing hormone analogs should be implemented 3 to prevent new episodes of pneumothorax, especially in patients who wish to preserve their reproductive potential.…”

Bilateral pleural endometriosis

“…Medical therapy should be considered as the first line of treatment 21 . Current medical treatment regimens include danazol 21,22 or GnRH agonists 23–25 . However, the recurrence of hemothorax following hormonal therapy is well documented 2,26 , 27 .…”