H-Index
14
Scimago Lab
powered by Scopus
eISSN: 2373-3586
call: +1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Logo

Medical Science Monitor Basic Research
MSM

Annals
ISI-Home

Get your full text copy in PDF

Spontaneous Pneumothorax in a Patient with Advanced Scleroderma: A Case Report

Viki Kumar, Keerat Rai Ahuja, Nfn Anila, Muhammad Aurangzeb, Theo Trandafirescu

(Department of Internal Medicine, Icahn School of Medicine at Mount Sinai/Queens Hospital Center, Jamaica, USA)

Med Sci Case Rep 2017; 4:34-36

DOI: 10.12659/MSCR.902080


BACKGROUND: Spontaneous pneumothorax may be primary or secondary. There are many causes of secondary spontaneous pneumothorax. Spontaneous pneumothorax in association with scleroderma has been rarely reported.
CASE REPORT: A 41-year-old man presented to the emergency department with sudden-onset dyspnea for 1 day. He denied having chest pain, palpitations, trauma, or other symptoms. Physical exam included mild tachycardia, tachypnea, Raynaud’s phenomenon, and sclerodermal skin changes on extremities, face, and trunk. Lab data included anti-topoisomerase >8 and antinuclear antibody (1: 2560). A chest x-ray revealed a large left pneumothorax with marked compression of the lung field and right-sided tracheal deviation. The patient’s past medical history included 1 year of severe progressive sclerosis, recurrent pneumothorax on right side status post chest tube placement, multiple bronchoscopies, right-sided video-assisted thoracoscopic surgery for persistent air leak, and muscle-sparing thoracotomy with right upper lobectomy. This time, the pneumothorax had recurred on the left side. A chest tube was inserted, resulting in lung expansion with symptom resolution. A post-chest tube CT scan chest showed severe paraseptal and centrilobular emphysematous changes with biapical bullous changes marked in the left apex. Within 3 days, the patient had another episode of dyspnea, with a chest x-ray showing recurrent left pneumothorax. Manipulating and changing the chest tube did not bring any improvement, so a blood patch pleurodesis was done. No recurrence was noted in the next 4 weeks.
CONCLUSIONS: Physicians should consider pneumothorax as one of the potential complications in patients with chronic scleroderma with underlying pulmonary fibrosis and sub-pleural cysts.

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
I agree