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Case Reports
. 2007 Jul-Aug;14(5):295-7.
doi: 10.1155/2007/141028.

Catamenial hemoptysis and pneumothorax in a patient with cystic fibrosis

Chris M Parker  1 , Robert Nolan, M Diane Lougheed
Affiliations
Case Reports

Catamenial hemoptysis and pneumothorax in a patient with cystic fibrosis

Chris M Parker et al. Can Respir J. 2007 Jul-Aug.

Abstract
in English, French

Hemoptysis or pneumothorax that recurs with the onset of menses is strongly suggestive of thoracic endometriosis syndrome (TES). TES is a rare disorder, with relatively few cases reported in the literature. A 32-year-old woman with cystic fibrosis, who over a period of several months had experienced recurrent catamenial hemoptysis and pneumothoraces, including an episode of life-threatening hemoptysis that coincided with menstruation, is presented. Thoracic computed tomography and magnetic resonance imaging scans, as well as a bronchoscopic evaluation that demonstrated endobronchial lesions that disappeared after menses, support the diagnosis of TES in the present patient. The patient was treated empirically with danazol and subsequently underwent a successful double-lung transplantation. Danazol was discontinued postoperatively, and she was started on an oral contraceptive. Eighteen months post-transplant, she has not experienced a recurrence of her catamenial symptoms, despite having resumed a regular menstrual cycle.

Une récurrence d’hémoptysies ou de pneumothorax à l’apparition des menstruations est fortement évocatrice d’une endométriose thoracique (ET). L’ET est un trouble rare, et relativement peu de cas ont été déclarés dans les publications. Est présenté le cas d’une femme de 32 ans atteinte de fibrose kystique qui, pendant plusieurs mois, a souffert d’hémoptysies et de pneumothorax cataméniaux récurrents, y compris un épisode d’hémoptysie mettant sa vie en danger qui a coïncidé avec ses menstruations. La tomodensitométrie thoracique, l’imagerie par résonance magnétique et une évaluation bronchoscopique qui ont révélé des lésions endobronchiques qui ont disparu après les menstruations soutenaient le diagnostic d’ET. La patiente a subi un traitement empirique au danazol et a ensuite subi une double greffe pulmonaire réussie. La patiente a cessé de prendre du danazol après l’opération, et on lui a prescrit un contraceptif oral. Dix-huit mois après la greffe, elle n’avait vécu aucune récurrence des symptômes cataméniaux, même si elle avait retrouvé un cycle menstruel régulier.

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Figures

Figure 1)
Figure 1)
Corresponding slices of thoracic computed tomography scans taken during menses (A) and mid-cycle (B). Images taken during menses demonstrated the presence of pulmonary parenchymal lesions (white arrows) consistent with hemorrhage, which were no longer evident on a scan taken approximately two weeks later when the patient was mid-cycle
See this image and copyright information in PMC

References

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