A New Variant of Combined Pulmonary Fibrosis and Emphysema From Second-Hand Smoke: A Case Report and Review of Literature

Rafay Khan, Sunil Tulpule, Nneka Iroka, Shuvendu Sen, Teena Mathew, Mohammad Islam, Abdalla Yousif, Stacey Longo


The findings of combined pulmonary fibrosis along with emphysema have been increasingly recognized in the medical literature. Patients presenting with such findings are usually found to be heavy smokers or former smokers. Their presentations begin with severe respiratory distress that gets progressively worse. They are found to have low diffusion capacity (DLCO) although spirometry will show preserved lung volumes. No prior research has presented a documented case of such a fatal condition in a young person with no prior history of smoking. In this case report, we discuss the presentation, diagnosis, and management of a young 29-year-old non-smoker with increasing shortness of breath with a complicated hospital course discovered to have an abnormal variant or presentation ofcombined pulmonary fibrosis and emphysema (CPFE). As most published studies have attributed these findings as a secondary response to a history of smoking, other etiologies and risk factors have yet to be properly analyzed resulting in prolonged hospital course and often missed diagnoses.

J Clin Med Res. 2015;7(10):812-816
doi: http://dx.doi.org/10.14740/jocmr2277w


Emphysema; Pulmonary fibrosis; Smoker; Second-hand smoke; Lung diseases

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