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

Abstract

Catamenial pneumothorax is a rarely encountered entity characterized by recurrent pneumothorax concurrent with menstruation. Numerous mechanisms have been postulated in the etiology of catamenial pneumothorax and treatment is still controversial. We report a case of a catamenial pneumothorax successfully treated with a Gn-RH analogue supporting the efficacy of this regimen and the endometriosis theory as an underlying cause of the disease.

Catamenial pneumothorax revisited: Clinical approach and systematic review of the literature

“…Hormonal therapy is a secondary therapeutic option, especially when considering the systemic nature of the disease. Use of a gonadotropin-releasing hormone analog can cure CPT 80 ; however, before initiating pharmacologic disruption of ovarian steroid genesis in a young woman, all surgical treatment options should have been exhausted.…”

Hormonal therapy after the operation for catamenial pneumothorax – is it always necessary?

“…The bone density is usually restored 2 years after treatment cessation [ 21 , 22 ]. However, unlike the widely accepted period of six months of hormonal treatment as sufficient to avoid recurrences [ 23 ], there are no data about the benefit of this kind of treatment if initiated after more than 6 months or later after the operation. As presented, although none of our patients underwent a postoperative hormonal treatment, no pneumothorax recurrences were registered during a follow up of 18, 36 and 8 months.…”

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 .…”