Understanding Paraseptal Emphysema
Paraseptal emphysema is a type of chronic obstructive pulmonary disease (COPD) affecting air sacs (alveoli) near lung septa, the thin walls separating lung lobules and lining the pleura. Damage concentrates in peripheral lung areas, adjacent to these septa and pleural surfaces.
Air sacs in these regions become damaged and enlarged, forming bullae (air-filled blisters). Unlike centrilobular or panlobular emphysema, paraseptal damage is along the lung’s edges and near fibrous septa. This impairs gas exchange, often trapping air.
Recognizing the Symptoms
Paraseptal emphysema symptoms often develop gradually and unnoticed until advanced. A primary symptom is shortness of breath, initially during activity and later at rest. This breathlessness arises because damaged air sacs cannot properly exchange gases, leading to reduced oxygen in the bloodstream.
Common symptoms include a persistent cough (with or without mucus). Wheezing, a whistling sound, occurs as airways narrow due to inflammation and trapped air. Fatigue is another symptom, from increased breathing effort and reduced oxygen. These symptoms indicate lung impairment but are not exclusive to paraseptal emphysema.
Identifying the Causes
Paraseptal emphysema develops from prolonged exposure to lung-damaging irritants. Cigarette smoke is the primary risk factor; its chemicals trigger inflammation and break down elastic fibers, destroying and enlarging alveoli and surrounding tissues.
Secondhand smoke also damages lungs. Environmental factors like air pollution (particulate matter, industrial fumes) irritate airways. Occupational exposures to dusts (silica, coal) or chemicals contribute. A rarer genetic cause is Alpha-1 Antitrypsin Deficiency (AATD), a protective protein deficiency making lungs vulnerable to damage, even in non-smokers.
Diagnosing the Condition
Diagnosis starts with medical history and physical examination (listening to lung sounds). History covers smoking habits, occupational exposures, and family lung disease. Lung function tests, such as spirometry, measure air volume and flow rate to assess lung capacity and airflow obstruction.
High-resolution computed tomography (HRCT) scans are key in confirming diagnosis. HRCT provides detailed cross-sectional lung views to visualize the damage pattern. Doctors look for air-filled sacs or bullae at the lung periphery, near the pleura or interlobular septa. This imaging helps differentiate paraseptal emphysema from other types and lung conditions.
Managing and Treating Paraseptal Emphysema
While paraseptal emphysema damage is irreversible, treatment focuses on managing symptoms, preventing further progression, and improving quality of life. For smokers, cessation is the most effective step to halt lung damage progression and improve lung function. Medications like bronchodilators relax airway muscles to ease breathing.
Corticosteroids (inhaled or oral) may reduce airway inflammation and prevent flare-ups. For severe cases with low blood oxygen, oxygen therapy provides oxygen. Pulmonary rehabilitation programs, including exercise training, nutritional counseling, and breathing techniques, are beneficial to improve endurance and manage symptoms. In severe cases, surgical options like lung volume reduction surgery (LVRS) or lung transplantation may be considered.