Earlier this week, a report about the risk of air travel causing pneumothoraces in Birt-Hogg-Dubé syndrome patients was published in the American Journal of Respiratory and Critical Care Medicine. This study was performed by Professor Pieter Postmus’ and his team at the the VU Medical Center in the Netherlands.
Postmus et al. (2014) describe the case of a 38 year-old man with BHD who developed a pneumothorax after taking a speed lift to the top of one of the highest towers in the world. This episode was also two days following a trans-Atlantic flight. Upon his return home, the patient reviewed when his previous episodes of pneumothorax had occurred in relation to his flight pattern. He found that both of his previous pneumothoraces had occurred within ten days of his return flights.
The authors also conducted a study of 190 BHD patients and found that 12 patients (6%) suffered 13 episodes of pneumothorax within one month of flying. Of these, six cases occurred within 10 days; 4 cases between 10-20 days, and 3 cases between 20-30 days of the flight. This time lag is thought to be due to the time taken for air to build up in the pleural cavity following cyst rupture caused by air travel.
The authors suspect that flying may cause a small pneumothorax to develop, which is then aggravated by further air pressure changes, most commonly the return flight. The authors suggest that patients should be assessed for pneumothorax before the return flight.
These results suggest that roughly 1 in 16 BHD patients are at risk of developing a pneumothorax following air travel, and that patients should be aware that they are at risk for up to one month following the flight.