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Spontaneous pneumothorax associated with ankylosing spondylitis
1Department of Emergency Medicine, National Taiwan University Hospital, School of Public Health, National Taiwan University, Taipei, Taiwan.
Rheumatology (Oxford, England)
|August 18, 2005
Summary
Spontaneous pneumothorax is rare in ankylosing spondylitis (AS) unless lung disease is present. Recurrences are common, suggesting prophylactic treatment for initial pneumothorax in AS patients.
Area of Science:
- Rheumatology
- Pulmonology
- Thoracic Surgery
Background:
- Ankylosing spondylitis (AS) is a chronic inflammatory disease primarily affecting the axial skeleton.
- Pulmonary complications, including spontaneous pneumothorax, are not well-characterized in AS patients.
Purpose of the Study:
- To determine the incidence and clinical features of spontaneous pneumothorax in patients diagnosed with ankylosing spondylitis.
- To evaluate risk factors and outcomes associated with pneumothorax in this population.
Main Methods:
- Retrospective observational cohort study.
- Review of chest radiographs and medical records of 1028 ankylosing spondylitis patients from 1993-2003.
- Analysis of patients with spontaneous pneumothorax, including lung disease and treatment outcomes.
Main Results:
- The overall incidence of spontaneous pneumothorax in AS patients was 0.29%.
- Patients with apical fibrotic lung changes had a higher incidence (13.6%) of pneumothorax.
- Recurrences were common, with two patients undergoing video-assisted thoracoscopic surgery (VATS) and one receiving talc pleurodesis.
Conclusions:
- Spontaneous pneumothorax is rare in AS without underlying fibrocystic lung disease.
- Cigarette smoking may be a significant co-factor.
- Prophylactic interventions should be considered for the first episode of spontaneous pneumothorax in AS patients due to high recurrence rates.