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Pneumothorax
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===Secondary spontaneous=== Secondary spontaneous pneumothorax occurs in the setting of a variety of lung diseases. The most common is [[chronic obstructive pulmonary disease]] (COPD), which accounts for approximately 70% of cases.<ref name=Rosen2010/> The following known lung diseases may significantly increase the risk for pneumothorax. {| class="wikitable" ! scope="col" | Type ! scope="col" | Causes |- ! scope="row" | Diseases of the airways<ref name=Tschopp/> | COPD (especially when [[bullous emphysema]] is present), [[asthma|acute severe asthma]], [[cystic fibrosis]] |- ! scope="row" | Infections of the lung<ref name=Tschopp/> | [[Pneumocystis pneumonia]] (PCP), [[tuberculosis]], [[pneumonia|necrotizing pneumonia]] |- ! scope="row" | [[Interstitial lung disease]]<ref name=Tschopp/> | [[Sarcoidosis]], [[idiopathic pulmonary fibrosis]], [[Langerhans cell histiocytosis|histiocytosis X]], [[lymphangioleiomyomatosis]] (LAM) |- ! scope="row" | [[Connective tissue disease]]s<ref name=Tschopp/> | [[Rheumatoid arthritis]], [[ankylosing spondylitis]], [[polymyositis]] and [[dermatomyositis]], [[systemic sclerosis]], [[Marfan's syndrome]] and [[Ehlers–Danlos syndrome]] |- ! scope="row" | [[Cancer]]<ref name=Tschopp/> | [[Lung cancer]], [[sarcoma]]s involving the lung |- ! scope="row" | Miscellaneous<ref name=Noppen/> | [[Catamenial pneumothorax]] (associated with the [[menstrual cycle]] and related to [[endometriosis]] in the chest) |} In children, additional causes include [[measles]], [[echinococcosis]], inhalation of a [[foreign body]], and certain [[congenital malformation]]s ([[congenital pulmonary airway malformation]] and [[Pneumatosis#Congenital lobar emphysema|congenital lobar emphysema]]).<ref name="Robinson">{{cite journal | vauthors = Robinson PD, Cooper P, Ranganathan SC | title = Evidence-based management of paediatric primary spontaneous pneumothorax | journal = Paediatric Respiratory Reviews | volume = 10 | issue = 3 | pages = 110–7; quiz 117 | date = September 2009 | pmid = 19651381 | doi = 10.1016/j.prrv.2008.12.003 }}</ref> 11.5% of people with a spontaneous pneumothorax have a family member who has previously experienced a pneumothorax. Several hereditary conditions – [[Marfan syndrome]], [[homocystinuria]], [[Ehlers–Danlos syndromes]], [[alpha 1-antitrypsin deficiency]] (which leads to [[Pneumatosis#Lungs|emphysema]]), and [[Birt–Hogg–Dubé syndrome]] – have all been linked to familial pneumothorax.<ref name="Chiu">{{cite journal | vauthors = Chiu HT, Garcia CK | title = Familial spontaneous pneumothorax | journal = Current Opinion in Pulmonary Medicine | volume = 12 | issue = 4 | pages = 268–272 | date = July 2006 | pmid = 16825879 | doi = 10.1097/01.mcp.0000230630.73139.f0 | s2cid = 45908721 }}</ref> Generally, these conditions cause other signs and symptoms as well, and pneumothorax is not usually the primary finding.<ref name=Chiu/> Birt–Hogg–Dubé syndrome is caused by mutations in the ''FLCN'' [[gene]] (located at [[chromosome 17]]p11.2), which encodes a protein named [[folliculin]].<ref name=Robinson/><ref name=Chiu/> ''FLCN'' mutations and lung lesions have also been identified in familial cases of pneumothorax where other features of Birt–Hogg–Dubé syndrome are absent.<ref name=Robinson/> In addition to the genetic associations, the [[human leukocyte antigen|HLA]] [[haplotype]] A<sub>2</sub>B<sub>40</sub> is also a genetic predisposition to PSP.<ref name="Fishman1520">{{Cite book |vauthors=Levine DJ, Sako EY, Peters J | title=Fishman's Pulmonary Diseases and Disorders |url=https://archive.org/details/fishmanspulmonar00afis |url-access=limited | publisher=McGraw-Hill | year=2008 | page=[https://archive.org/details/fishmanspulmonar00afis/page/n1551 1520] | edition=4th | isbn=978-0-07-145739-2 }}</ref><ref name="Light307">{{Cite book | vauthors = Light RW | title=Pleural diseases | publisher=Lippincott Williams & Wilkins | year=2007 | page=307 | edition=5th | isbn=978-0-7817-6957-0 }}</ref>
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