Total pleurectomy as the surgical treatment for recurrent secondary spontaneous pneumothorax in a child with severe pulmonary Langerhans cells histiocytosis

Aziz, Dayang Anita Abdul; Rahman, Nur Afdzillah Abdul; Tang, Swee Fong; Latif, Hasniah Abdul; Zaki, Faizah Mohd; Annuar, Zulfiqar M.; Alias, Hamidah; Latiff, Zarina Abdul

doi:10.1136/bcr.09.2011.4734

Cited by 3 publications

(2 citation statements)

References 13 publications

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“…Other surgical interventions are needed when there is no improvement in respiratory functions after 12-week course of chemotherapy; persistent pneumothorax due to chest tubes or worsening of CT scan findings during follow-up. 13 The conservative treatment of recurrent pneumothoraces in PLCH usually fails since the underlying lungs are very fragile and tend to collapse easily. The recurrence rate of pneumothorax treated with chest tube is only 58%.…”

Section: Discussionmentioning

confidence: 99%

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Bilateral Pulmonary Langerhans's Cell Histiocytosis is Surgical Challenge in Children: A Case Report

Soyer

Özyüksel

Boybeyi

et al. 2019

European J Pediatr Surg Rep

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Background Pulmonary Langerhans's cell histiocytosis (PLCH) is a rare cause of interstitial lung disease in children and more than half of the cases are bilateral. Persistent respiratory distress due to spontaneous pneumothorax (SP) in bilateral PLCH may refractory to conservative treatment and posed a great challenge to surgical modalities. A 3-year-old boy with SP due to bilateral PLCH is presented to discuss the surgical options of recurrent and refractory PLCH cases in children. Case Report The patient was admitted to the emergency department with severe respiratory distress and SP. After chest tube insertion, biopsy from neck mass revealed Langerhans's cell histiocytosis. Chemotherapy including vinblastine and prednisone was initiated. Due to persistent respiratory difficulty and air leaks, talc pleurodesis and thoracoscopic bullae excision with pleural decortication were performed. Two months after the admission, due to nosocomial infection and severe respiratory distress, extracorporeal membranous oxygenation (ECMO) support was initiated. The patient was died of ECMO complications on 24th day of ECMO. Conclusion Despite the use of chemotherapy and surgical excision of cystic lesions, bilateral PLCH in children may have lethal outcome. Other treatment options including respiratory support with ECMO and lung transplantation should be considered as last resort of treatment alternative in persistent cases.

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Section: Discussionmentioning

confidence: 99%

“…Abdul Aziz et al reported that mechanical pleurodesis is superior to chemical pleurodesis. 13 It can be performed by either with thoracotomy or thoracoscopy. It is not considered as a contraindication for transplantation.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Pulmonary Langerhans's Cell Histiocytosis is Surgical Challenge in Children: A Case Report

Soyer

Özyüksel

Boybeyi

et al. 2019

European J Pediatr Surg Rep

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Pleurodesis in Pulmonary Langerhans Cell Histiocytosis in Children: A Life-Saving Measure

Prakash

Durugappa

Ramachandran

et al. 2019

Indian Journal of Medical and Paediatric Oncology

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Isolated pulmonary Langerhans cell histiocytosis (LCH) is uncommon in children. Often recurrent pneumothorax complicates therapy and contributes to morbidity. Chemotherapy does not always prevent the complications of pneumothorax. We report here a young girl with isolated pulmonary LCH who presented with respiratory failure, successfully treated with chemotherapy, and pleurodesis. We report this case to highlight the use of pleurodesis in this setting.

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Pleurodesis in Children with Povidone-Iodine: A New Intrapleural Drug

Devaraj¹,

Maheswari²,

Ramachandran³

et al. 2022

The Indian Journal of Chest Diseases and Allied Sciences

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Total pleurectomy as the surgical treatment for recurrent secondary spontaneous pneumothorax in a child with severe pulmonary Langerhans cells histiocytosis

Cited by 3 publications

References 13 publications

Bilateral Pulmonary Langerhans's Cell Histiocytosis is Surgical Challenge in Children: A Case Report

Bilateral Pulmonary Langerhans's Cell Histiocytosis is Surgical Challenge in Children: A Case Report

Pleurodesis in Pulmonary Langerhans Cell Histiocytosis in Children: A Life-Saving Measure

Pleurodesis in Children with Povidone-Iodine: A New Intrapleural Drug

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