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

## TL;DR

A young non-smoker developed a rare lung condition typically linked to smoking, highlighting the need to explore other causes of combined pulmonary fibrosis and emphysema.

## Contribution

This case report presents a non-smoking young patient with a rare variant of combined pulmonary fibrosis and emphysema.

## Key findings

- The patient was a 29-year-old non-smoker with severe respiratory distress and abnormal lung findings.
- The case suggests that CPFE may have causes beyond smoking, which could lead to missed diagnoses.
- Current literature lacks understanding of non-smoking-related etiologies for this condition.

## Abstract

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 of “combined 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.