Spontaneous pneumothorax and pneumomediastinum in IPF

Franquet, Tomás; Giménez, A.; Torrubia, Sofía; Sabaté, Josep M.; Rodríguez-Arias, J.M.

doi:10.1007/s003300050014

Cited by 75 publications

(58 citation statements)

References 12 publications

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“…1,10,11 These disorders were also present in our cohort of patients. Among the less common predisposing factors encountered were bronchiolitis obliterans syndrome in allogeneic hematopoietic stem cell recipients, intrathoracic malignancies, and focal cystic or cavitary lesions.…”

Section: Discussionsupporting

confidence: 64%

Spontaneous Pneumomediastinum: Analysis of 62 Consecutive Adult Patients

Iyer

Joshi

Ryu

2009

Mayo Clinic Proceedings

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OBJECTIVE:To clarify the clinical presentation and course of patients with spontaneous pneumomediastinum (SP) and to determine the usefulness of diagnostic testing in these patients. PATIENTS AND METHODS:We conducted a retrospective review of 62 consecutive adult patients (age ≥18 years) diagnosed as having SP during an 11-year period from July 1, 1997, to June 30, 2008. The study cohort included 41 men and 21 women (median age, 30 years; interquartile range, 20-69 years).RESULTS: Among the 62 study patients, the most common presenting symptoms were chest pain (39 patients [63%]), cough (28 [45%]), and dyspnea (27 [44%]). Preexisting lung diseases were identified in 27 patients (44%) and included interstitial lung disease, asthma, lung malignancies, bronchiolitis obliterans syndrome, chronic obstructive pulmonary disease, bronchiectasis, and cystic lung lesions. The initial diagnosis of SP was achieved by chest radiography in 52 patients (84%); the remaining cases were diagnosed by computed tomography. Forty-seven patients (76%) were hospitalized for a median duration of 2.5 days. Additional diagnostic procedures were performed in 27 patients (44%) and included contrast esophagography, bronchoscopy, and esophagogastroduodenoscopy; however, they did not yield a pathologic cause in any patient. Pneumothorax was identified in 20 patients (32%), but less than one-third of these patients underwent chest tube thoracostomy. No episodes of mediastinitis or sepsis occurred. Recurrence of SP was seen in 1 patient, and thoracoscopic surgery was performed in 1 patient for persistent air leak (pneumothorax). CONCLUSION:Spontaneous pneumomediastinum was associated with a relatively benign clinical course; however, pneumothorax was seen in 32% of cases. Diagnostic testing to determine a pathologic cause yielded little clinically relevant information in these patients.

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Section: Discussionsupporting

confidence: 64%

Spontaneous Pneumomediastinum: Analysis of 62 Consecutive Adult Patients

Iyer

Joshi

Ryu

2009

Mayo Clinic Proceedings

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“…All forms of thoracic air leak are defined as ALS according to Franquet et al, 12 including spontaneous pneumomediastinum or pneumopericardium, SE, interstitial emphysema and spontaneous PT. There have been only a few reports about ALS associated with SCT.…”

Section: Discussionmentioning

confidence: 99%

Air-leak syndrome following allo-SCT in adult patients: report from the Kanto Study Group for Cell Therapy in Japan

Sakai

Kanamori

Nakaseko

et al. 2010

Bone Marrow Transplant

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We retrospectively investigated air-leak syndrome (ALS), including pneumothorax and mediastinal/s.c. emphysema, following allogeneic hematopoietic SCT. Eighteen patients (1.2%) developed ALS among 1515 undergoing SCT between 1994 and 2005 at the nine hospitals participating in the Kanto Study Group on Cell Therapy. The median onset of ALS was at 575 days (range: 105-1766) after SCT and 14 patients (77.8%) had experienced late onset noninfectious pulmonary complications (LONIPC) before ALS. Chronic GVHD (cGVHD) was the strongest risk factor for ALS (odds ratio 13.5, P ¼ 0.013 by multivariate analysis). Repeat SCT, male sex and age o38 years at the time of transplantation were also significant risk factors for ALS. Patients with ALS had a significantly worse survival rate than those without ALS (61.5 vs 14.9% at 3 years; P ¼ 0.000). The main cause of death was respiratory complications in 8 of the 18 patients. In conclusion, ALS is a rare complication of SCT that is more likely to occur in relatively young male patients with cGVHD and/or LONIPC. It is possible that better understanding and treatment of LONIPC may lead to prevention of ALS.

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“…A few cases have been reported in which pneumomediastinum developed in patients with systemic sclerosis, systemic lupus erythematosus or rheumatoid arthritis (5-7). Pneumomediastinum occurs in 5-15% of patients with idiopathic pulmonary fibrosis, although it is not a fatal complication (8,9). To our knowledge, this is the first reported case of MPA complicated by both IP and pneumomediastinum.…”

Section: Discussionmentioning

confidence: 80%

Pneumomediastinum in a Patient with Microscopic Polyangiitis Preceded by Interstitial Pneumonia

et al. 2014

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A 73-year-old woman was diagnosed with interstitial pneumonia in 2006; however, the disease was not progressive. Four years later, purpura, peripheral neuropathy, and increased levels of myeloperoxidase antineutrophil cytoplasmic antibodies (583 EU/mL) and C-reactive protein (2.27 mg/dL) were observed, and a diagnosis of microscopic polyangiitis was made. Treatment with prednisolone and azathioprine was initiated. However, on the 35th hospital day, chest computed tomography showed pneumomediastinum and subcutaneous emphysema without aggravation of the interstitial pneumonia. To our knowledge, this is the first report of pneumomediastinum as a complication of microscopic polyangiitis associated with interstitial pneumonia.

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Spontaneous pneumothorax and pneumomediastinum in IPF

Cited by 75 publications

References 12 publications

Spontaneous Pneumomediastinum: Analysis of 62 Consecutive Adult Patients

Spontaneous Pneumomediastinum: Analysis of 62 Consecutive Adult Patients

Air-leak syndrome following allo-SCT in adult patients: report from the Kanto Study Group for Cell Therapy in Japan

Pneumomediastinum in a Patient with Microscopic Polyangiitis Preceded by Interstitial Pneumonia

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