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CONCLUSIONS This case underscores that acupuncture can result in complications such as a pneumothorax from puncture of the pleura. These types of AEs from acupuncture can be avoided with a better understanding of anatomical differences, including body mass index and variations in depth associated with body size, musculature, or skeletal structure. When placing the needles, it is crucial for practitioners to know that the depth at which vital organs lie may differ between patients.BACKGROUND Angiopoietinlike protein 5 (ANGPTL5) is an ad