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COPD (Chronic Obstructive Pulmonary Disease)

How Can a Non-Smoker Have Emphysema?

08/17/2010

Question:

I am writing on behalf of my son. He is 22 and has been told by doctors in Lithuania that he has emphysema. He has never smoked-I am not a smoker-and we do not understand how he can have Emphysema when he does not smoke!

He has had both lungs operated on after suffering from several pneumothoraxes. His left lung was operated on in May and he had an MRI done Friday, August 13, and you can see a pocket of air almost 4 cm in diameter on the top of the left lung. He is complaining of ‘popping’ and fatigue and is worried that the lung is collapsing again. It collapsed a week after the surgery this May. What can he do?

Answer:

Emphysema can occur rarely in young nonsmokers but the cause in that case is often obscure. Alpha 1-antitrypsin deficiency should be considered by his physician. However, from the description you provided it appears that he has subpleural blebs that have contributed to his pneumothoraces.

I would recommend that you have him evaluated by a lung specialist to help differentiate what is going on with him and to help with the next therapeutic decision.

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Response by:

Mark D Wewers, MD Mark D Wewers, MD
Professor of Pulmonology, Allergy, Critical Care & Sleep
Molecular Virology, Immunology & Medical Genetics
Environmental Health Sciences
College of Medicine
The Ohio State University