Letter to the Editor. July 21, 2007

Spontaneous Pneumothorax is seen in patients with Marfanoid habitus.

Jaime F. Bravo, MD

Former Clinical Professor of Medicine (Rheumatology) University of Colorado Medical Center. Denver. Colorado. USA.

Rheumatology Department, San Juan de Dios Hospital. Santiago. Chile.

Financial support: None.

I read with interest the article by Hilling: “Recurrent Pneumothorax in a patient with Rheumatoid Arthritis and Leflunomide Treatment”(1), I wonder if this patient had Marfanoid habitus. Is well known (2,3) that patients with Marfan syndrome or with Joint Hypermobility Syndrome (JHS) with Marfanoid habitus, may develop spontaneous pneumothorax (SP).

In our paper to be presented in the Annual Arthritis Meeting (2007): “Clinical Study of 1124 Cases of Ehlers-Danlos Syndrome (Classic EDS, JHS and Vascular EDS)” We found SP in 2 patients with JHS and in 5 relatives of patients. We also found associated arthritis such as RA in 15% of JHS. Usually not even good rheumatologists do not diagnose JHS. Previously at EULAR (4) we described Marfanoid habitus in 15.4% of 972 JHS cases.

Furthermore we have discussed a similar problem, in a letter to the Editor, regarding the occurrence of SP in 3 patients with ankylosing spondylitis (5). 

References:

1. D. E. Hilling, P. M. van den Berg, A. C.F. Makkus, F. van der Straaten, P. W. Plaisier: Recurrent Pneumothorax In A Patient With Rheumatoid Arthritis On Leflunomide Treatment: Case Report And Overview Of The Literature. The Internet Journal of Rheumatology. 2007. Volume 3 Number 1.

2.- Bravo, JF, Wolff  C . Clinical Study of Hereditary Disorders of Connective Tissues in a Chilean Population. Joint Hypermobility Syndrome and Vascular Ehlers-Danlos Syndrome. Arthritis Rheum 2006; 54 (2): 515-523.

4.- Personal Web Page: www.reumatologia-dr-bravo.cl

4.- Bravo, JF, Wolff C, Correa S. Clinical Study of 972 Rheumatological Patients with Joint Hypermobility Syndrome (JHS), Using the Brighton Criteria. Ann Rheum Dis 2007;66 (Suppl II):244.

5.- Bravo JF. Spontaneous Pneumothorax is seen in the Joint Hypermobility Syndrome (JHS). Rheumatology 2006; 45 (8): 1052 – 53.