Chest
Bullous Pulmonary Damage in Users of Intravenous Drugs
Section snippets
MATERIALS AND METHODS
All patients in this study had chest roentgenographic evidence of bullous pulmonary damage13 and were divided according to whether they additionally were users of intravenous drugs (group 1) or not (group 2). They were found in one of three ways. First, the three patients alluded to in the introductory paragraph were found to have bullous pulmonary damage after they were hospitalized for nonpulmonary problems (assigned to group 1). None of these patients had histories that suggested pulmonary
RESULTS
Twenty-six patients with bullous pulmonary damage were studied. Eleven were users of intravenous illicit drugs and were assigned to group 1; the remaining 15 patients, who did not use intravenous drugs, comprised group 2. All 26 patients were men and were cigarette smokers, but the duration and extent of cigarette use are not known.
Clinical characteristics of patients in group 1 and group 2 are presented in Table 1. All but one of the patients in group 1 were black (our population of drug users
DISCUSSION
We have compared two groups of patients with bullous pulmonary damage (both groups were cigarette smokers with chronic obstruction of the airways; one group was intravenous drug abusers and the other not). Clinical features distinguished these two groups, supporting our belief that bullous pulmonary damage and intravenous drug abuse are pathogenetically related. The group of drug abusers was younger than the nonusers. The drug users had large bullae confined exclusively to the upper lobes,
ACKNOWLEDGMENTS
We thank Ms. Fran Goldberg for her secretarial assistance.
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Reprint of: Pulmonary complications in cocaine users
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2020, Clinics in Chest MedicineCitation Excerpt :Giant bullae are rare and typically associated with cigarette smoking. Additionally, marijuana smoking,27 intravenous drug use,28 and human immunodeficiency virus infection29 have all been linked to the development of giant bullae. The clinical effect of bullous lung disease can vary widely.
Pulmonary complications in cocaine users
2020, Revue des Maladies RespiratoiresPrimary spontaneous pneumothorax due to high bleb burden
2016, Respiratory Medicine Case ReportsCitation Excerpt :He was adamant about not having used any illicit drugs or inhalational products of any kind for the past 1 year, but it is possible that he was not completely forthright. His prior IV drug use placed him at risk for developing IV drug abuse-associated apical bullous emphysema, talcosis leading to blebs, and the potential to contract the human immunodeficiency virus (HIV) and pneumocystis jiroveci that can lead to blebs and pneumothorax [10–13]. What made our case unique were the chest x-rays revealing blebs that could have predicted the patient's recurrent pneumothorax [14].
Bullous emphysema associated with drug abuse
2010, Revista Portuguesa de PneumologiaA young patient with a minimal smoking history presents with bullous emphysema and recurrent pneumothorax
2007, ChestCitation Excerpt :HIV infection confers an increased risk for emphysema when compared to control subjects (15% vs 1%, respectively), apparently due to the accelerated progression to emphysema in smoking HIV-positive individuals.5 Besides tobacco, bullous lung disease has been associated with marijuana,6 cocaine,7 and IV drug use,89 with the latter being the strongest association. Several autoimmune diseases have been implicated in bullous lung disease.
Manuscript received January 2; revision accepted August 7.