Rheumatology Advance Access originally published online on June 12, 2006
Rheumatology 2006 45(8):1052; doi:10.1093/rheumatology/kel165
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LETTER TO THE EDITOR |
Spontaneous pneumothorax are seen in the joint hipermobility syndrome (JHS)
San Juan de Dios Hospital, Rheumatology, Santiago, Chile
Correspondence to: J. F. Bravo. E-mail: jaime.bravos{at}gmail.com
SIR, I read with interest the article by Lee et al. [1] about the occurrence of spontaneous pneumothorax (SP) in three patients with ankylosing spondylitis (AS) from 1028 patients (0.30%). I wonder if they were Marfanoids with joint hypermobility syndrome (JHS).
In the last 5 years, I have seen 1081 JHS patients in my rheumatological clinic in Santiago, Chile, and in our article (to be published in February in Arthritis & Rheumatism) studying 249 patients with hereditary disorders of the connective tissues, 230 had JHS and of these 33 (14%) were Marfanoids; furthermore, two of them had SP (0.87%). SP is known to occur in patients with the Marfan syndrome as well as in patients having JHS with Marfanoid habitus. This body habitus is more frequent in Grahame et al.'s series [2] than in ours; they report 35%.
The authors noted that the three patients were slender and that Kawakami et al. [3] describe this body habitus as a risk factor for SP. I would like to know whether these patients were not only slender (like many Orientals) but also had Marfanoid habitus and if the Brighton Criteria were used to rule out JHS.
JHS patients can have an associated arthritis as noted in 19 patients (7%) in our study, of which six had AS, so I wonder what was the body habitus of the three patients with SP as described by Lee et al. 1], since it is possible that the cause or concomitant factor for the SP could have been the fragile pulmonary tissues seen in Marfanoids with JHS.
The author has declared no conflicts of interest.
References
- Lee C-C, Lee S-H, Chang I-J et al. Spontaneous pneumothorax associated with ankylosing spondylitis. Rheumatology 2005;44:1538–41.
[Abstract/Free Full Text] - Grahame R, Edwards JC, Pitcher D et al. A clinical and echocardiographic study of patients with the hypermobility syndrome. Annals Rheum Dis 1981;40:541–6.
[Abstract/Free Full Text] - Kawakami Y, Irie T, Kamishima K. Stature, ling hight, and spontaneous pneumothorax. Respiration 1982;43:35–40.[ISI][Medline]
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