Spontaneous pneumothorax are seen in the joint hipermobility syndrome (JHS)
Abstract
Sir, I read with interest the article by Lee et al. [1] about the occurrence of spontaneous pneumothorax (SP) in three patients with ankylosing spondylitis (AS) from 1028 patients (0.30%). I wonder if they were Marfanoids with joint hypermobility syndrome (JHS). In the last 5 years, I have seen 1081 JHS patients in my rheumatological clinic in Santiago, Chile, and in our article (to be published in February in Arthritis & Rheumatism) studying 249 patients with hereditary disorders of the connective tissues, 230 had JHS and of these 33 (14%) were Marfanoids; furthermore, two of them had SP (0.87%). SP is known to occur in patients with the Marfan syndrome as well as in patients having JHS with Marfanoid habitus. This body habitus is more frequent in Grahame et al.'s series [2] than in ours; they report 35%. The authors noted that the three patients were slender and that Kawakami et al. [3] describe this body habitus as a risk factor for SP. I would like to know whether these patients were not only slender (like many Orientals) but also had Marfanoid habitus and if the Brighton Criteria were used to rule out JHS.
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