Epidemiology of Spontaneous Pneumothorax in Women

doi:10.1378/chest.89.3.378

Chest

Volume 89, Issue 3, March 1986, Pages 378-382

https://doi.org/10.1378/chest.89.3.378 Get rights and content

An epidemiologic study was done on spontaneous pneumothorax in women. Six hundred sixty-four patients with spontaneous pneumothorax comprising 409 with idiopathic pneumothorax (61.6 percent), and 255 with secondary pneumothorax (38.4 percent) were studied. By age, idiopathic pneumothorax had its peak incidence in the 20s and secondary pneumothorax the 30s. Secondary pneumothorax included iatrogenic pneumothorax resulting from acupuncture treatment. The female patients were not so thin and tall as the male patients. The percentage of positive family history among the female patients was 4.42 percent in the idiopathic type and 0.45 percent in the secondary type. The percentage in the male idiopathic type of pneumothorax was 2.29 percent. Catamenial pneumothorax and pneumothorax with pulmonary hamartoangiomyomatosis are well known as specific in female subjects, but the cases are rare. Nonetheless, attention should be paid to femalespecific rare types, for the etiology of idiopathic pneumothorax.

Section snippets

Materials and Methods

The Pneumothorax Study Squad consists of the 20 respiratory specialists belonging to the national hospitals which are distributed in all Japanese areas and two advisers in epidemiology and clinical medicine.

We gathered all spontaneous pneumothorax data accumulated for 5,536 patients with spontaneous pneumothorax during the past eight years for all Japanese areas. For idiopathic pneumothorax, the number was 3,895 cases (70.4 percent), for secondary pneumothorax, the number was 1,641 cases (29.6

Age Distribution (Fig 1)

As shown in Figure 1, the relative incidences of idiopathic pneumothorax and secondary pneumothorax have been arranged with respect to age brackets. The 20-year age bracket reveals the highest incidence of 34.47 percent, presenting a high-rise single-peak curve. From the age of 30, the curve shows a moderate fall with advancing years.

Secondary pneumothorax occurred in the 30-year age bracket at a relatively high incidence of 21.9 percent. The curve has a single-peak path exhibiting a moderate

Discussion

With the increase in the number of spontaneous pneumothorax cases, there has also been an increasing number of reported cases of catamenial pneumothorax as a specifically female condition. The mechanism for the development of this condition is being argued at present. In contrast to the normal or general form of idiopathic pneumothorax, this condition has come to be treated as a special form of the disease. The nature of catamenial pneumothorax is associated with ectopic endometritis through

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Thoracic endometriosis and lymphangioleiomyomatosis: Coincidence or hormonal rational?
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La lymphangioléïomyomatose (LAM) et l’endométriose sont deux maladies de la femme jeune. La principale complication thoracique est le pneumothorax.
Nous rapportons le cas d’une femme de 45 ans ayant présenté un pneumothorax droit. Le contexte clinique et les constatations peropératoires nous ont orienté vers une localisation thoracique de l’endométriose alors que l’histologie de la biopsie pulmonaire et les constats de l’évolution sont en faveur d’une LAM. Cette présentation évoque la coexistence de ces deux maladies, une situation possible mais jamais décrite dans la littérature. Elle pose la question de l’intérêt d’une biopsie pulmonaire systématique dans l’endométriose thoracique.
La LAM et l’endométriose semblent être deux pathologies sous influence hormonale. À ce jour, nous ne savons pas s’il y a un lien entre les deux ou s’il s’agit juste d'une association fortuite.
Lymphagioleiomyomatosis (LAM) and endometriosis are two diseases that occur in young women. The main thoracic complication of both diseases is pneumothorax.
We describe the case of a 45-year-old woman who presented with a right-sided pneumothorax. The clinical context and the perioperative findings were suggestive of thoracic endometriosis, while the histology of the pulmonary biopsy and the evolution of her case were in favour of LAM. This presentation indicates the coexistence of the two diseases, which has never previously been described in the literature. The case raises the question as to whether it should be policy to systematically undertake a pulmonary biopsy in cases of thoracic endometriosis.
LAM and endometriosis are both diseases under hormonal influence. To date, we do not know if there is any direct link between the two diseases or if the presentation that we describe here occurred by chance.
Age and Clinical Presentation for Primary Spontaneous Pneumothorax
2020, Heart Lung and Circulation
Citation Excerpt :
Indeed, the average age of onset in males is 26.6 years, while in females it is 30.9 years. Finally, a double peak in incidence was found: the first between 15 and 30 years of age; the second between 40 and 45 years of age [4–17]. Regarding symptoms, pain and dyspnoea in its various forms (frequently reported as breathlessness, tachypnoea, and fatigue) were the most often reported.
Primary spontaneous pneumothorax (PSP) is a commonly known condition due to the accumulation of air in the pleural space in otherwise healthy people, without apparent underlying lung disease. To date, the exact pathogenesis of PSP is unclear, but it still represents a public health issue. We performed a review of the literature concerning the epidemiology of PSP, examining age of onset and presentation symptoms, in order to assess the possible correlation between these characteristics and its occurrence. Data concerning age, signs, and symptoms were collected. For description purposes, information regarding aetiological and anthropomorphic data was also gathered. In total, 265 papers were evaluated. Regarding age of onset, PSP is a disease that can occur in a broad age group with a double cluster (15–30 and 40–45 yr). Regarding symptoms, pain and dyspnoea (in its various forms) are the most described in PSP. Pain was recorded in 69.25% (range, 9–100%) of the population studied, whereas dyspnoea was present in an average of 54.55% (range, 27–77.1%). Tobacco exposure seems to play an important role in the early onset of PSP. Concerning age at presentation, this review highlights that PSP can occur over a broad age range. The literature appears to be consistent in reporting PSP occurrence mostly below 45 years of age. Asymptomatic PSP is an almost unseen entity. Finally, of pollutants, cigarette smoking should be considered as the most significant exogenous risk factor in the development of PSP.
Primary Spontaneous Pneumothorax in Menstruating Women Has High Recurrence
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Primary spontaneous pneumothorax (PSP) is treated on the basis of studies that have predominantly consisted of tall male subjects. Here, we determined recurrence of PSP in average-statured menstruating women and studied prevalence of catamenial pneumothorax (CP) in this population.
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PSP in healthy average-statured menstruating women has high recurrence compared with male counterparts. CP is a clinical diagnosis and often recurs despite hormonal suppression therapy.
A manifestation of endometriosis that will take your breath away: A case report
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: Manuscript received April 24; revision accepted August 8.

^†: Pneumothorax Study Squad in Japan. Other members are: Drs. M. Akutagawa, M. Aoki, K. Egawa, T. Hagiwara, M. Hayakawa, K. Ikegaki, R. Izuchi, S. Izumi, K. Kudo, M. Miyamori, H. Nagano, H. Nakajima, I. Omura, S. Sakai, T. Sato, K. Shigematsu, S. Suzuki, S. Yaguchi, and Y. Yamamoto.

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Chest

Clinical InvestigationsEpidemiology of Spontaneous Pneumothorax in Women

Section snippets

Materials and Methods

Age Distribution (Fig 1)

Discussion

Chest

Conservative management of spontaneous pneumothorax

Thorax

Chronic recurring spontaneous pneumothorax due to endometriosis of the diaphragm

JAMA

Pulmonary lymphangio-myomatosis

AJR

Clinical Investigations
Epidemiology of Spontaneous Pneumothorax in Women