title: Spontaneous pneumothorax in flight as first manifestation of alpha-1 antitrypsin deficiency.
abstract: Alpha-1 antitrypsin deficiency is a genetic condition that increases the risk of a variety of conditions including pulmonary emphysema and chronic liver disease. We report on a 33-yr-old male fighter pilot with early-onset pulmonary emphysema with bullae who developed spontaneous pneumothorax during in-flight combat training. A CT scan of his chest after removal of the chest tube showed multiple variably sized bullae and pulmonary cysts scattered throughout both lungs. Serum levels of alpha-1 antitrypsin were markedly decreased. Genetic analyses showed a PI ZZ genotype. Alpha-1 antitrypsin deficiency often goes undiagnosed by flight surgeons, which is a risk to flight safety.
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: Yi-Chang
authors.initials: YC
authors.lastname: Lin
authors.forename: Wen-Kuan
authors.initials: WK
authors.lastname: Chiu
authors.forename: Hung
authors.initials: H
authors.lastname: Chang
authors.forename: Yeung-Leung
authors.initials: YL
authors.lastname: Cheng
authors.forename: Jen-Chin
authors.initials: JC
authors.lastname: Chen
mesh_terms: D000328:Adult; D000337:Aerospace Medicine; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008889:Military Personnel; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000209:etiology*; D011656:Pulmonary Emphysema / Q000209:etiology; D011859:Radiography; D019896:alpha 1-Antitrypsin Deficiency / Q000150:complications / Q000175:diagnosis*