Entries in LAM (2)


Rare Lung Disease Hits Women in Their Prime

File photo. Medioimages/Photodisc/Thinkstock(NEW YORK) -- Sarah Poitras was 28 when she first noticed being short of breath as she climbed her six-flight walk-up apartment in New York City. But soon it got worse, and she couldn't even navigate the short subway stairs on her way to work.

Doctors initially thought she had asthma, but after a year of false diagnoses and worsening breathing, Poitras learned she had a rare and sometimes progressive lung disease: lymphangioleiomyomatosis, or LAM. Sometimes fatal, it strikes women in the prime of their lives and there is no cure.

"You think that you're lucky because you are not faced with only having six months [to live], but it's the unknown that's scary," Poitras, now 31, said. "I have no idea. The first doctor said it could be seven years [to live] or it could be 20. My current physician won't give me any sort of number. She's pragmatic and wants me to live every day."

In LAM, an unusual kind of smooth muscle cell grows uncontrollably and invades the airways, blood and lymph vessel in the lungs. The accumulation of LAM cells form clusters and cysts, which destroy healthy tissue. Over time, these cells create holes in the lungs and make breathing a daily battle.

The LAM Foundation, which was founded in 1995 to provide education, research and support for patients, is aware of 1,500 cases of the disease worldwide. But they estimate there might be as many as 250,000 people who have gone undiagnosed or misdiagnosed. There is a genetic link between LAM and tuberous schlerosis, another rare disease that causes tumors to form, especially in the kidney. About 40 percent of all LAM patients also have kidney tumors.

In a worst-case scenario, a woman might have total lung collapse and need a lung transplant. Others can live a relatively normal life with some shortness of breath. Because LAM does not show up on a standard X-ray, more complex tests such as CT scans and lung biopsies, among others, are required for a proper diagnosis.

The disease begins most often during the childbearing years. Poitras, who works in health care marketing, was officially diagnosed at 30 last June, six months after she married.

She and her husband had talked about having children, but that is now out of the question. Doctors believe that the hormone estrogen might play a role in causing LAM and pregnancy might speed up its progression.

But many doctors, even pulmonary specialists, are unaware of the disease's symptoms and often misdiagnose it as asthma, bronchitis, or emphysema. Early diagnosis can lead to earlier treatment that helps slow the progression of the disease.

"The disease is just brutal," said Jill Raleigh, executive director of the Cincinnati-based LAM Foundation, which was responsible for setting up the first national registry of patients.

But there is hope. The foundation has actively supported research, including the MILES study, which was published in March in the New England Journal of Medicine. The immunosuppressant drug Sirolimus showed promise in some women with moderate LAM.

Scientists are also looking at blood markers that can predict the progression of the disease. "The progression is not the same in all women," she said. "There isn't a typical LAM patient.  Psychologically, what I hear from most patients when they are first diagnosed is there aren't any other LAM patients," Raleigh said. "They are alone in the disease."

Poitras, a newcomer to the foundation, is now its top fundraiser, Raleigh said.

With medications, her breathing has improved and her health is stable, although Poitras needs oxygen to exercise, an important routine to keep the rest of her body healthy.

She and her husband, Justin Poitras, 31, an information security specialist, make the most of their young marriage and their love of travel. The couple has already seen Tokyo, Spain, Amsterdam, Germany, and Copenhagen. They plan to go to Iceland in August.

"My husband and friends and family keep me upbeat and the possibility that I could be part of something bigger in finding a cure," Poitras said. "I am not crazy optimistic. I am not stupid. I know what this means. But to be able to participate in science is pretty interesting."

Copyright 2011 ABC News Radio´╗┐


Transplant-Rejection Drug Is First Treatment for Rare Lung Disease

Hemera Technologies/Thinkstock(CINCINNATI) -- The drug sirolimus (Rapamycin) is the first to produce any benefit for women who suffer from a rare lung disease called lyphangioleiomyomatosis, or LAM.  The disease has had no cure, and until now, no suitable treatments.

While sirolimus has already been approved as a transplant-rejection drug, a study released Wednesday in the New England Journal of Medicine reports that when given to LAM patients, lung function and quality of life is improved.

LAM is the loss of lung function due to the abnormal growth of muscle tissue causing airway obstruction.  Internationally, an estimated 250,000 women are undiagnosed or misdiagnosed, according to the LAM Foundation.

The study's lead author, Dr. Francis X. McCormack of the University of Cincinnati and scientific director of the LAM Foundation, noted the "rare and special" nature of the treatment's discovery, but said that stabilized lung function only occurred "for as long as patients took the drug."  If a patient stopped taking the drug, a decline in lung function would resume, McCormack said.

McCormack added that sirolimus costs around $8 a tablet, and that the recommended dosage is two tablets a day.

Jill Raleigh, executive director of the LAM Foundation, indicated the treatment isn't likely to be a cure-all for everyone.

"It's not a cure," she said. "But it's hope."

Copyright 2011 ABC News Radio ´╗┐

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