European Journal of Biomedical and Pharmaceutical Sciences

A RARE CASE OF VANISHING LUNG SYNDROME WITH HEPATITIS-B

Dr. Pulkit Gupta*, Dr. G. N. Srivastava, Dr. Anbarasan Thirua, Dr. A. Tiwari, Dr. A. Jaina, Dr. S. S. Dash,
Dr. A. Suresh, Dr. Gowthami B. and Dr. K. S. Sravani

ABSTRACT

Vanishing lung syndrome (VLS) is a rare disorder otherwise known as idiopathic giant bullous emphysema, typically occurs in young, thin male smokers but cases have been diagnosed in middle aged men as well. In this disorder emphysematous bullae appear in the lung, alveolar walls gradually disintegrate to form large air spaces with eventual atrophy of the lung and[1-3] and compression of the adjacent side. The basic pathogenesis is not exactly known, however it has been attributed to[2] possible respiratory myositis. Vanishing Lung Syndrome was first described in a case report by Burke in 1937.[4] Since then several more case reports have been published in various journals worldwide.[5-8] It is most often confused with pneumothorax and inadvertent insertion of intercostal drainage is not a rarity even among reported cases.[5,8] The patients have little or no evidence of cough or respiratory infection[1] and finally die in respiratory failure. The radiographic criteria for this syndrome defined by Roberts et al include the presence of giant bullae in one or both upper lobes, occupying at least one third of the hemithorax and[9] compressing surrounding normal parenchyma. VLS is also known as type I bullous disease or primary bullous disease of the lung in which the lungs appear to be[10] disappearing on X-ray. Surgical resection of giant bullae is the treatment of choice, the indications include spontaneous pneumothorax, infection, or dyspnoea, the[11-15] best results are seen following limited bullectomy. Thoracoscopic treatment of giant bullae is an effective alternative to conventional thoracotomy with minimal[16] morbidity.

Keywords: spontaneous pneumothorax, infection, or dyspnea.