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Friday, March 7, 2014
COPD (Chronic Obstructive Pulmonary Disease)
Emphysema in a young nonsmoker
I am a 30-year-old working woman. I suffered multiple chest infections at childhood and was diagnosed with asthma at 18 years. I had multiple hospitalizations and acute crisis with asthma and was on high dose IV, oral, inhaled and nebulized steroids, bronchodilators and other medicines. A recent CT scan detected emphysematous and bronchiectatic changes in both lungs. I have never smoked but have been exposed to second hand smoke.
Now I suffer from shortness of breath and easy exhaustion on walking for a short distance or climbing more than two flights of stairs. My question is
Can asthma cause long term structural damage to the lungs?
Although I have never smoked how can I have emphysema t such a young age?
Is emphysema and bronchiectasis progressive?
Now I am taking 4 puffs of Seroflo 250 twice daily and salbutamol SOS. Doctor had given me Tiotropium bromide, which gave me good relief from SOB, but I was averse to having it since I thought it was only meant for the COPD patients and insisted on stopping it. Will it be a good idea to ask my doctor about starting it again?
What can I do to reduce the SOB and enhance my energy level? Thanks for your time and valued answer.
Thank you for visiting NetWellness and for your questions. Only a health professional performing a thorough clinical exam is able to evaluate your symptoms and discuss your case specifically.
There are a couple of points that you raise that can be discussed, though. The first is the notion of emphysema in a nonsmoker. Cigarette smoking is by far the most common cause of emphysema, but there are others. Chronic exposure to other particles such as fumes, chemicals, and dust can cause lung disease. Alpha-1 Antitrypsin deficiency is an inherited defect that can cause early emphysema in smokers and nonsmokers. It is very likely that there are other genetic causes that have not yet been described. Chronic malnutrition, connective tissue disorders, HIV, and drug use are other known causes of emphysema.
Second, asthma can cause long-term structural damage to the lungs, but that does not generally happen at age 30. The combination of emphysema and bronchiectasis raises other possibilities such as cystic fibrosis. It is also possible to develop complications of asthma, like allergic bronchopulmonary aspergillosis that can happen with bronchiectasis.
A lung specialist can assist in further evaluating your condition and answering your questions.
Michael E Ezzie, MD
Clinical Assistant Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University