Vanishing lung syndrome and HIV infection: an uncommon yet potentially fatal sequela of cigarette smoking

Silent Vanishing Lung Syndrome: Severe Emphysema in an Asymptomatic Patient

Vanishing lung syndrome (VLS) is an uncommon condition characterized by idiopathic giant bullous emphysema, resulting in the lungs appearing abnormally small on radiological scans. Some case reports have suggested a potential association between the development of this condition in young males, individuals with a history of heavy tobacco smoking, methamphetamine, and marijuana use, and those previously diagnosed with HIV. The primary diagnostic tools for vanishing lung syndrome include initial x-rays and high-resolution CT scans, which play a crucial role in confirming the diagnosis. The management of vanishing lung syndrome varies based on several factors, including the patient's functional status and the size and location of the bullae, with treatment options ranging from conservative approaches to surgical interventions. In this case report, we present the case of a 42-year-old male who was a heavy tobacco smoker, had a history of methamphetamine and marijuana use, and was previously diagnosed with HIV. He initially presented to the emergency department seeking poly-substance detoxification but was incidentally found to have giant bullous emphysema on chest imaging. After stabilizing the patient, he was discharged with instructions to follow up with a pulmonologist in two months.

Vanishing Lung Syndrome: A Case Report and Systematic Review of the Literature

Vanishing lung syndrome (VLS), also known as idiopathic giant bullous emphysema, is defined by the emergence of sizable bullae causing compression on healthy lung tissue. The elusive etiology of VLS mandates a diagnosis based on radiographic evidence showcasing giant bullae occupying at least one-third of the hemithorax in one or both lungs. This report presents a case of VLS in a 36-year-old female smoker devoid of any prior medical history. Additionally, we conducted a systematic review to discern the demographics, risk factors, and treatment modalities for individuals diagnosed with VLS.

Reduced levels of interleukin‑1 receptor antagonist act as a marker for pneumonia in the elderly

Pneumonia is a disease causing serious inflammation and infection of the lungs and accounts for >50,000 mortalities annually. The elderly are at an increased risk of developing pneumonia. Pneumonia is more serious in the elderly than in any other age group due to the increased inflammation and risk of community‑acquired pneumonia associated with aging. Interleukin‑1 receptor antagonist (IL‑1RA) is an anti‑inflammatory protein that counteracts the destructive effects of inflammatory proteins. Therefore, the possible association between pneumonia in elderly individuals and reduced levels of IL‑1RA was investigated in the present study. The number of lymphocytes was counted in all subjects and the relative protein expression levels of IL‑1RA were determined using western blot analysis. In addition, the immunological activities of IL‑1RA were measured using ELISA. The results demonstrated that the numbers of lymphocytes in the serum and bronchoalveolar lavage fluid (BALF) were significantly higher in elderly patients than those in young patients. Furthermore, the serum and BALF levels of IL‑1RA in elderly patients were significantly lower than those in young patients (P<0.05 and P<0.01, respectively). Therefore, reduced levels of IL‑1RA in BALF may act as a marker for pneumonia in the elderly and may be a potential adjuvant for the diagnosis of pneumonia in elderly individuals. The results also showed that smoking was associated with significant reductions in the levels of IL‑1RA in the BALF of elderly patients. The association between smokers and non‑smokers found in this study provides support for the hypothesis that smoking may contribute to the pathogenesis of pneumonia by further reducing IL‑IRA levels in certain elderly patients.