Emphysema (cont.)
What are the causes or risk factors for emphysema?
- The main cause of emphysema is
smoking, which activates inflammatory cells in
the lung. This inflammation causes; 1) swelling within the bronchioles, and 2)
activation of enzymes called proteases which attack and destroy lung tissue (the
alveolar wall structures).
- There is a genetic predisposition to emphysema. The relatively rare condition
known as alpha 1-antitrypsin deficiency is the genetic deficiency of a chemical
that protects the lung from damage by proteases.
- Emphysema is also a component of aging. As the lungs get older, the elastic
properties decrease, and the tensions that develop can result in small areas of
emphysema.
Other less common causes of emphysema include:
- Intravenous drug use in which some of the non-drug additives like corn
starch can be toxic to lung tissue
- Immune deficiencies in which infections like Pneumocystis carinii can cause
inflammatory changes in the lung
- Connective tissue illnesses (Ehlers-Danlos Syndrome, Marfan syndrome) in
which abnormal elastic tissue in the body can cause alveoli to fail
In underdeveloped countries, a common cause of emphysema is indoor air
pollution. In these populations, it is very common to have indoor stoves in the
kitchen. The smoke from cooking results in the damage to the lungs.
What are symptoms of emphysema?
Emphysema is a progressive disease that usually manifests itself in patients
after 50 years of age. Emphysema is a subtype of
chronic obstructive pulmonary
disease (COPD in the US, COLD in the United Kingdom). Most patients, except in
those in whom disease is the result of a genetic deficiency (alpha-1 antitrypsin
deficiency), have variable manifestations of the different components of COPD
which include:
Each of
the subtypes has characteristic symptoms; those primarily associated with
emphysema are shortness of breath and wheezing. Initially the shortness of
breath (dyspnea) occurs with activity; as time continues and the disease
progresses, the episodes of dyspnea occur more frequently eventually occurring
at rest.
Next: How is emphysema diagnosed? »
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