**8. Genetics and pneumothorax**

A lot of work needs to be done in the field of spontaneous pneumothorax that runs in families. Genetic profiling in patients presenting with pneumothorax might be indicated, in the hope of finding defective genes that expose conditions such as Marfan, Ehler Danlos and Birt-Hogg-Dubé syndromes [82]. These have one thing in common, defective connective tissue. Patients may or may not have pre-existing lung cysts before their pneumothoraces, which can be bilateral and recurrent. Risk stratification of other siblings needs to be calculated and predicted [83]. The importance of this subject is realised by frequent flyers, pilots, airhostesses and scuba divers. They need to know the risk and whether prophylactic procedures would be a wise thing to go for. By the same token patients who are expected to require lung transplantation at one stage in their life, such as cystic fibrosis patients, require special consideration of treatment. Pleurodesis seems to render transplantation a difficult task, but this is not a prohibitive contraindication. It might be prudent to discuss the case with a lung transplantation centre before embarking on such treatment [84].
