ORDINARY YET BIZARRE: A RARE PULMONARY LYMPHANGIOLEIOMYOMATOSIS (LAM) CASE IN PREGNANT LADY WITH COMMON PRESENTATION

Abstract

Introduction

Lymphangioleiomyomatosis (LAM) is a rare disease that occurs usually in women in child-bearing age. It is most commonly diagnosed during pregnancy with pneumothorax as the common preliminary symptoms.       

Case Report

31 years old lady with no known medical illness, in her fourth pregnancy at 38 weeks period of gestation presented with short history of shortness of breath and right sided chest pain. She was then immediately brought to hospital from Klinik Kesihatan with impression of pulmonary embolism. Initially the plan was to immediately send the patient to tertiary center but the plan was cancelled. At district hospital via thorough physical examinations revealed that this patient was actually having right sided pneumothorax whereby chest tube immediately inserted to relieve the symptoms. She was then transferred to tertiary hospital. During the course of admission, she was having recurrent pneumothorax with multiple times chest tube insertion and was diagnosed as LAM after high resolution CT and transferred to hospital with cardiothoracic surgeon availability.        

Discussion & Conclusion

LAM is a rare cystic lung disease affecting women in reproductive age group. Pneumothorax is the most common presentation of this diseases and it occurs frequently during pregnancy. Even though to diagnosed LAM required high end laboratory and radiological investigations, to diagnosed pneumothorax as its early presentation requires only good clinical history and physical examinations. All medical personal should not underestimate the importance of good clinical examinations as rare case like LAM also presented with common presentation.