Abstract
Pneumothorax in patients with progressive systemic sclerosis (PSS) often presents as a difficult-to-treat disease. Autologous blood-patch pleurodesis has previously been used for the treatment of pneumothorax. Blood outside its own environment is an irritant; therefore, chest physicians must watch closely for an allergic reaction. The injection is simple, painless, causes no side effects, is an inexpensive treatment for pneumothorax and is available not only in patients with persistent air leak but also in those with residual air space. A case is reported here of blood-patch pleurodesis for pneumothorax in lung fibrosis due to PSS. As an alternative therapy for difficult-to-treat pneumothorax in patients with PSS with persistent air leak and residual air space, autologous blood-patch pleurodesis would be one of the treatment options.
Highlights
Pneumothorax is not a rare complication of lung fibrosis due to progressive systemic sclerosis (PSS); a number of patients with PSS who have extensive pulmonary fibrosis with enlarged sub-pleural blebs and honeycomb lungs have been shown to develop pneumothorax
Diffuse interstitial fibrosis is the most common pulmonary manifestation and pneumothorax is usually associated with the pulmonary complication of interstitial fibrosis [1]
Immunosuppressants including corticosteroids, which are frequently used for PSS, may aggravate persistent air leak; pneumothorax in patients with PSS often presents as a difficult‐to‐treat disease and prognosis is predicted to be poor
Summary
Pneumothorax is not a rare complication of lung fibrosis due to progressive systemic sclerosis (PSS); a number of patients with PSS who have extensive pulmonary fibrosis with enlarged sub-pleural blebs and honeycomb lungs have been shown to develop pneumothorax. Various treatment options have been described [1]. Surgery is a treatment option for recurrent and refractory pneumothorax. Chemical pleurodesis with talc or minocycline is another treatment option, but there were complication with deterioration of pulmonary fibrosis especially in patients with pulmonary fibrosis. The success rate of the of PSS patients with pneumothorax appeared to be unsatisfactory. The purpose of this case report is to report the usefulness of this successful treatment
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