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Severe bullous emphysema associated with cocaine smoking
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Pulmonary emphysema is characterised by permanent enlargement of airspaces distal to the terminal bronchiole accompanied by destruction of alveolar walls. The loss of elastic tissue contained in the interalveolar septa is caused by an imbalance between proteinase and antiproteinase activity, most commonly caused by cigarette smoking. Congenital deficiency of α1-antitrypsin, the most well known antiproteinase, is an important risk factor for the development of premature emphysema. In addition, various other causes have been reported including intravenous drug abuse,1 , …