Bilaterally repeated spontaneous pneumothorax with ankylosing spondylitis

Abstract

Ankylosing spondylitis is a chronic inflammatory disease that primarily affects the joints of the axial skeleton. Pleuropulmonary involvement is an uncommon, late event in the course. A 53-year-old man who had a diagnosis of ankylosing spondylitis since he was 40 years old developed a bilaterally repeated and refractory spontaneous pneumothorax. He was treated successfully with surgery to the left pneumothorax that had been refractory to conservative chest tube drainage and chemical pleurodesis. During the second episode of right-side pneumothorax, he developed severe respiratory insufficiency because of his coexisting restrictive lung disease. He was successfully treated with chemical pleurodesis to the right pneumothorax. In our experience, prophylactic treatment such as surgery and pleurodesis should be considered for patients with ankylosing spondylitis during the first episode of pneumothorax.

Outcome of Video-assisted Thoracoscopic Surgery for Spontaneous Secondary Pneumothorax

“…Most common underlying parenchymal lung diseases have been COPD [6] in western countries and pulmonary tuberculosis [7,8] in the East, but the incidence of spontaneous pneumothorax complicating pneumocystis carinii pneumonia has increased recently in western countries due to the prevalence of acquired immune deficiency syndrome [9]. Other etiologies include idiopathic pulmonary fibrosis [10], ankylosing spondylitis [11], multiple sclerosis [12], and cystic fibrosis [13]. While therapeutic algorithm for primary spontaneous pneumothorax has been well-established [14], treatment of secondary pneumothorax has remained to be defined.…”

Acute Respiratory Events in Connective Tissue Disorders

“…Treatment of air leak syndromes in CTDs is not always effective and includes oxygen therapy, chest tube insertion, pleurodesis, or surgical interventions. Optimal therapy of the underlying CTD and any complication such as infection is indispensable for the ideal management of this rare respiratory manifestation in CTDs [170,171,172,173,174,175,176,177,178,179,180,181]. …”

Imaging of Lung Disease Associated with Connective Tissue Disease

“…195 Patients are prone to superadded fungal or mycobacterial disease, 191 193 and spontaneous pneumothorax, which may be recurrent and bilateral. 196 197…”

“…195 Patients are prone to superadded fungal or mycobacterial disease, 191,193 and spontaneous pneumothorax, which may be recurrent and bilateral. 196,197 The advent of HRCT allowed for the fuller assessment of the pleuroparenchymal and airway disease associated with AS. Alongside the findings described above, parenchymal micronodules, parenchymal bands, bronchial wall thickening, and bronchiectasis have all been reported.…”