title: [A case of early-onset COPD with recurrent pneumothorax].
abstract: Early-onset chronic obstructive pulmonary disease (COPD) is designated as onset under age 50. We report a case of early-onset COPD with recurrent pneumothorax. A 29-year-old woman visited our hospital with productive cough and dyspnea on exertion. CT scan of the chest demonstrated severe panlobular emphysema. A pulmonary function test showed a reduction in FEV1.0 (41% of the predicted value). A diagnosis of severe COPD was made. Her symptoms and pulmonary function improved after the treatment of inhaled corticosteroid, long-acting beta2-agonist, and anti-cholinergic drugs. She had pneumothorax at least 8 times in the right lung. The level of alpha1-antitrypsin was normal. On the basis of the characteristics of the appearance of the chest X-ray and CT scan, the possibility of bronchiolitis obliterans, lymphoangioleiomyomatosis or Langerhans cell histiocytosis was thought to be low. We considered that several factors, such as high susceptibility, pulmonary infection during her childhood, bronchial asthma, malnutrition, smoking history from an early age, and long-term passive exposure to cigarette smoke may have contributed to the development of early-onset COPD in the present case.
authors.affiliation: Department of Internal Medicine, Tokyo Dental College.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Terashima
authors.forename: Tatsu
authors.initials: T
authors.lastname: Matsuzaki
authors.forename: Rika
authors.initials: R
authors.lastname: Ogawa
authors.forename: Asuka
authors.initials: A
authors.lastname: Naitou
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Morishita
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Ishizaka
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D006801:Humans; D011030:Pneumothorax / Q000150:complications*; D029424:Pulmonary Disease, Chronic Obstructive / Q000209:etiology; D012008:Recurrence