Recurrent Pneumothorax Complicated by Pleuroparenchymal Fibroelastosis Successfully Treated With Pleurodesis Using 50% Glucose: A Case Report

Pleuroparenchymal fibroelastosis (PPFE), a rare interstitial lung disease primarily affecting the upper lung lobes, leads to pleural thickening and subpleural fibroelastosis. Patients with PPFE are often prone to recurrent pneumothorax because their lung tissues are fragile and do not expand properly. Here, we report a case of recurrent pneumothorax associated with PPFE that was successfully treated with pleurodesis using a 50% glucose solution. A 66-year-old non-smoking woman presented with a right pneumothorax and underwent thoracoscopic bullectomy after imaging revealed a pulmonary bulla and bilateral apical infiltrates. PPFE was confirmed via histopathological examination. Although the initial recovery after surgery was uneventful, the pneumothorax recurred on postoperative day 16. The patient declined repeat surgery, and pleurodesis was performed using a 50% glucose solution because of her minocycline allergy. Following the procedure, she developed transient pleural effusion, which subsequently resolved; lung re-expansion was achieved, and no recurrence was observed on follow-up imaging. This case highlights that glucose pleurodesis may be a safe and effective alternative treatment for recurrent pneumothorax in patients with PPFE when conventional therapies are unsuitable.