Valentín-Mendoza Samuel, Nieves-Nieves José, Fernández-Medero Rosángela, Fernández-Gonzales Ricardo, Adorno-Fontánez José, Adorno-Fontánez Edgardo
Pulmonary Medicine San Juan City Hospital, San Juan Puerto Rico.
Bol Asoc Med P R. 2013;105(3):64-9.
Pulmonary lymphangioleiomyomatosis is an uncommon disease of unknown etiology characterized by the proliferation of abnormal smooth muscle cells in the lungs, leading to parenchymal destruction and progressive respiratory failure. The natural history of this disease remains poorly understood, primarily seen in women of childbearing age. The diagnosis can be difficult because symptoms are nonspecific and very similar to other respiratory diseases like asthma, emphysema and bronchitis. Lymphangioleiomyomatosis may not be diagnosed until a pneumothorax, chylothorax, interstitial lung disease or angiomyolipomas are discovered. The recent advances in genetic and molecular research provide new hope to discover the intricate mechanism of disease and evaluate new therapies. Internists, primary care physicians and pulmonologists should be aware of this condition in order to avoid delay in the diagnosis and institute appropriate therapy. The clinical features, pathophysiology, molecular genetics and medical treatment will be reviewed.
肺淋巴管平滑肌瘤病是一种病因不明的罕见疾病,其特征是肺部异常平滑肌细胞增殖,导致肺实质破坏和进行性呼吸衰竭。这种疾病的自然史仍知之甚少,主要见于育龄女性。由于症状不具特异性且与哮喘、肺气肿和支气管炎等其他呼吸系统疾病非常相似,诊断可能会很困难。直到发现气胸、乳糜胸、间质性肺病或血管平滑肌脂肪瘤,淋巴管平滑肌瘤病才可能被诊断出来。基因和分子研究的最新进展为发现疾病的复杂机制和评估新疗法带来了新希望。内科医生、初级保健医生和肺科医生应该了解这种疾病,以避免诊断延误并采取适当的治疗措施。本文将对其临床特征、病理生理学、分子遗传学和药物治疗进行综述。