Abstract
Pneumothorax and pneumomediastinum sometimes occur in patients with idiopathic interstitial pneumonias (IIPs). Although steroid treatment is commonly used for IIPs, some reports indicated that this treatment could cause pneumothorax (PT) or pneumomediastinum (PM) in patients with IIPs. The aim of the present study was to evaluate the clinical features of PT and PM in patients with IIPs, and to assess their association with steroid treatment. We enrolled 77 patients with IIPs and divided them into four groups: (1) idiopathic pulmonary fibrosis (IPF) patients without PT and PM [IPF PT/PM(-) group, n = 38]; (2) IPF patients with PT and/or PM [IPF PT/PM(+) group, n = 6]; (3) non-IPF patients without these complications [non-IPF PT/PM(-) group, n = 29]; and (4) non-IPF patients with PT and/or PM [non-IPF PT/PM(+) group, n = 4]. We reviewed and compared the clinical, radiological and laboratory findings among the four groups. We also focused on the above 10 IIPs patients with PT and/or PM to describe the details of their clinical features. Resultingly, IPF PT/PM(+) and non-IPF PT/PM(+) groups showed low percentage of vital capacity (%VC) compared with IPF PT/PM(-) and non-IPF PT/PM(-) groups, respectively. Six of the 10 cases with PT/PM were treated with steroids about 2 weeks before the development of PT and/or PM. We concluded that PT and PM could arise in patients with IIPs, especially in cases with severe restrictive ventilatory impairment. Our results further suggest that clinicians should be aware of these complications after starting steroid treatment for interstitial lung diseases.
