Beim j, hoofstein v.

From Breast, 06/01/99

Shindzhi Teramoto

In a recent issue of Chest (November 1998), Judson and strange [1] discussed rationally, that sarcoidosis caused bullous emphysema in three cases pulmonary sarcoid. Although bullae may occur in patients with healthy lungs, most bullae develop in smokers with emphysema tsentrodolevaya. Thus, smoking is the most risk factor in the development of bullous emphysema. However, the mechanism and causes of bullous emphysema have not fully understood. Thus, the current comprehensive report is important. Giant bullae may occur in patients with sarcoidosis and late stages of disease, and it seems bullosa emphysema or disappearance of symptoms. [2-5] Despite the increased frequency of emphysema with age and found most often in patients in the seventh decade, bullous emphysema occurs mainly in young patients. In addition, surgery, including flap to reduce the volume, especially useful for those who bullous emphysema and sarcoid bullosa. [5-8] Sarcoidosis should be carefully considered in the differential diagnosis of bullous emphysema of the lungs in young patients with chronic airflow limitation (CAL), in addition to other genetic diseases, including [[Alpha]. sub. 1]-antitrypsin disease, Fabry disease, Sally, kutis laxa and Elersa-Danlosa. [5] There is no doubt that sarcoidosis is a cause of bullous emphysema of the lungs in young patients with CAL, but the pathogenesis of large blisters in patients with sarcoidosis remains to be determined. Interestingly, bullous emphysema can be found in dogs, cats and puppies. Hoover and his colleagues [9] suggested that congenital weakness of the bronchial cartilage and lung torsion might be involved in the development of bullous emphysema in a baby. This may, in particular, supports the hypothesis of the authors that endobronhialnoy sarcoidosis lesions of the bronchi and bronchioles causes remodeling bronchial tree and respiratory tract. Further investigation and reports to clarify pathology and etiology of sarcoid bullosa. Mailing address: Shindzhi Teramoto, MD, FCCP Department of geriatric medicine, University of Tokyo Hospital, 7-3-1 Bunkyo-ku Hong, Tokyo, Japan 113-8655

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[9] Hoover JP, Henry G., Panciera RJ. Bronchial cartilage dysplasia with multifocal partial bullosa emphysema lasix furosemide and torsion in the puppy. J Am Vet Med Assoc 1992; 201:599-602