Catamenial pneumothorax in a 14-year-old female: A case report and literature review

Abstract

Background and aimsPneumothoraces can occur in patients of all ages and genders. We encountered a female adolescent patient who was experiencing recurrent pneumothoraces every several months. She endured an extensive workup to determine an etiology for her pneumothoraces but it was all negative. She was eventually diagnosed with catamenial pneumothorax. This is an established cause of recurrent pneumothorax in adults but is very rare in adolescent patients. Keeping it on the differential for any female of reproductive age with recurrent pneumothoraces may prevent potentially harmful and expensive diagnostic testing and procedures.MethodsWe reported a case of catamenial pneumothorax in an adolescent patient and reviewed the relevant literature.ResultsOur patient was a 14-year-old female patient with recurrent pneumothoraces every several months. She had an extensive procedural and genetic workup performed but no etiology was revealed. Due to a temporal relation of the pneumothoraces to menses, an obstetrics and gynecology consult was obtained. Empirical treatment for catamenial pneumothorax was started with a continuous oral contraceptive with combined estrogen-progestin leading to our patient's complete remission. Three years later our patient has not experienced any relapsing episodes of pneumothorax.ConclusionAlthough rare in younger patients, catamenial pneumothorax should be considered as a cause for recurrent pnueumothoraces in any post-pubertal female.

Pneumothorax in Children

“…The theorized mechanism is chronic airway inflammation that causes small airway obstructions and creates the pressure needed for air to escape into the pleural space. These conditions can make the lung pleura more susceptible to rupture and subsequent development of pneumothorax [15]. The most important symptom of SSP is dyspnea, tachypnea, and tachycardia.…”