Bullous lung disease due to marijuana.
OBJECTIVE
In contrast to the well-described effects of tobacco smoking upon pulmonary emphysema, with approximately 15% of smokers being affected at the age of 65 years, the effects of marijuana smoking are rarely reported and poorly understood.


METHODS
We report a series of 10 patients (mean age 41 +/- 9 years, eight male, two female), who presented over a period of 12 months to our respiratory unit with new respiratory symptoms, and who admitted to regular chronic marijuana smoking (>1 year continuously). Symptoms on presentation were dyspnoea (n = 4), pneumothorax (n = 4) and chest infection (n = 2).


RESULTS
High-resolution CT revealed asymmetrical, variably sized, emphysematous bullae in the upper and mid zones. However, the CXR was normal in four patients and lung function was normal in five.


CONCLUSIONS
Marijuana smoking leads to asymmetrical bullous disease, often in the setting of normal CXR and lung function. In subjects who smoke marijuana, these pathological changes occur at a younger age (approximately 20 years earlier) than in tobacco smokers.
Hii
Su W
SW
Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, Victoria, Australia.
Tam
Jeff D C
JD
Thompson
Bruce R
BR
Naughton
Matthew T
MT
D000328:Adult; D015331:Cohort Studies; D004417:Dyspnea / Q000209:etiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000473:pathology; D008297:Male; D008385:Marijuana Smoking / Q000009:adverse effects*; D008875:Middle Aged; D012129:Respiratory Function Tests; D014057:Tomography, X-Ray Computed; D014739:Victoria