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Spontaneous pneumothorax in Wegener granulomatosis
Isabelle Delèvaux1, Mehdi Khellaf, Marc André
1Department of Internal Medicine, CHU Clermont-Ferrand, Hôpital G Montpied, 58 rue Montalembert, 63003 Clermont-Ferrand, France. idelevaux@chu-clermontferrand.fr
Chest
|October 21, 2005
Summary
Spontaneous pneumothorax is rare in Wegener granulomatosis (WG), a vasculitis. Early pneumothorax in three patients, linked to subpleural nodules, resolved with immunosuppressive therapy.
Area of Science:
- Pulmonology
- Rheumatology
- Immunology
Background:
- Wegener granulomatosis (WG), a systemic vasculitis, can affect the lungs.
- Pulmonary manifestations in WG include nodules, which are often subpleural.
- Spontaneous pneumothorax is an uncommon but serious complication of WG.
Observation:
- This report details three cases of spontaneous pneumothorax occurring early in the course of WG.
- Case 1 presented with a pyopneumothorax, revealing the underlying vasculitis.
- Case 2 involved the rupture of a subpleural cavitary nodule into the pleural space.
- Case 3 showed pneumothorax concurrently with pulmonary hemorrhage.
Findings:
- All three patients experienced pneumothorax as an early manifestation of WG.
- The subpleural location of pulmonary nodules in WG predisposes to pleural rupture.
- Prompt immunosuppressive therapy led to improvement in all reported cases.
Implications:
- Early recognition of pneumothorax in WG is crucial for timely intervention.
- Subpleural cavitary nodules in WG warrant close monitoring for potential pleural complications.
- This highlights the importance of considering WG in patients presenting with unexplained pneumothorax, especially with other systemic symptoms.