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First published online on September 21, 2007
Chest, doi:10.1378/chest.07-0029
doi:10.1378/chest.07-0029
(Chest. 2007; 132:1140-1145)
© 2007 American College of Chest Physicians
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The Prevalence of Blebs or Bullae Among Young Healthy Adults*

A Thoracoscopic Investigation

Kayvan Amjadi, MD; Gonzalo G. Alvarez, MD, MPH; Eef Vanderhelst, MS; Brigitte Velkeniers, MD, PhD; Miu Lam, PhD and Marc Noppen, MD, PhD, FCCP

* From the Division of Respirology (Drs. Amjadi and Alvarez), University of Ottawa at The Ottawa Hospital, Ottawa, ON, Canada; Interventional Endoscopy Clinic (Ms. Vanderhelst, Dr. Velkeniers, and Dr. Noppen), Respiratory Division, University Hospital UZ Brussel, Brussels, Belgium; and Division of Epidemiology (Dr. Lam), Queen’s University, Kingston, ON, Canada.

Correspondence to: Kayvan Amjadi, MD, University of Ottawa, Ottawa Hospital, (Civic Campus), Division of Respirology, 1053 Carling Ave, Ottawa, ON, Canada K1Y 4E9; e-mail: kamjadi{at}ottawahospital.on.ca

Abstract

Background: To determine the prevalence of blebs or bullae using thoracoscopy in young healthy adults, and to compare patient characteristics among those with and without blebs.

Methods: Bilateral thoracoscopic evaluation of the lungs was performed in healthy individuals who were referred for thoracoscopic thoracic sympathectomy for essential hyperhidrosis. Participants were enrolled into a registry and followed for up to 9 years.

Results: Analysis was performed on 250 consecutive cases. Blebs were observed in 15 of 250 individuals (6%; male, n = 6; female, n = 9; mean age, 25.3 years; range, 15 to 51 years). Individuals with blebs had a significantly lower body mass index (BMI) [mean ± SD, 20.7 ± 2.4 kg/m2 vs 22.7 ± 3.4 kg/m2; p = 0.027] when compared to individuals without blebs, whereas all other parameters were similar. Blebs were most prevalent among slim individuals (BMI < 22 kg/m2) who smoked (odds ratio, 5.9; 95% confidence interval, 1.19 to 29.20).

Conclusion: Blebs were identified thoracoscopically in 6% of young healthy adults with no underlying lung disease. Low BMI in combination with smoking may have an important role in the development of pleural blebs in healthy young adults; however, these changes may not be responsible for future spontaneous pneumothoraces.

Key Words: essential hyperhidrosis • primary spontaneous pneumothorax • thoracoscopic thoracic sympathectomy






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