Document Detail


Mutational and radiographic analysis of pulmonary disease consistent with lymphangioleiomyomatosis and micronodular pneumocyte hyperplasia in women with tuberous sclerosis.
MedLine Citation:
PMID:  11520734     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Lymphangioleiomyomatosis (LAM) and multifocal micronodular pneumocyte hyperplasia (MMPH) produce cystic and nodular disease, respectively, in the lungs of patients with tuberous sclerosis. The objective of this study was to prospectively characterize the prevalence, clinical presentation, and genetic basis of lung disease in TSC. We performed genotyping and computerized tomographic (CT) scanning of the chest on 23 asymptomatic women with tuberous sclerosis complex (TSC). Cystic pulmonary parenchymal changes consistent with LAM were found in nine patients (39%). These patients tended to be older than cyst-negative patients (31.9 +/- 7.6 yr versus 24.8 +/- 11.6 yr, p = 0.09). There was no correlation between presence of cysts and tobacco use, age at menarche, history of pregnancy, or estrogen-containing medications. Three of the cyst-positive patients had a prior history of pneumothorax. Pulmonary function studies revealed evidence of gas trapping but normal spirometric indices in the cyst-positive group. All nine cyst-positive patients had angiomyolipomas (AML), which were larger (p < 0.05) and more frequently required intervention (p = 0.08) than cyst-negative patients (8 of 14 with AMLs, p < 0.05). Ten patients (43%) had pulmonary parenchymal nodules. Pulmonary nodules were more common in women with cysts (78% versus 21%, p < 0.05), and 52% of all patients had either cystic or nodular changes. TSC2 mutations were identified in all cyst-positive patients who were tested (n = 8), whereas both TSC1 and TSC2 mutations were found in patients with nodular disease. Correlation of the mutational and radiographic data revealed one pair of sisters who were discordant for cystic disease, two mother- daughter pairs who were discordant for nodular disease, and no clear association between cyst development and a specific mutational type. This prospective analysis demonstrates that cystic and nodular pulmonary changes consistent with LAM and MMPH are common in women with TSC.
Authors:
D N Franz; A Brody; C Meyer; J Leonard; G Chuck; S Dabora; G Sethuraman; T V Colby; D J Kwiatkowski; F X McCormack
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  164     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2001 Aug 
Date Detail:
Created Date:  2001-08-24     Completed Date:  2001-10-11     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  661-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA. d.franz@chmcc.org
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
DNA Mutational Analysis / methods
Female
Genotype
Humans
Hyperplasia
Kidney Diseases / genetics
Lung Neoplasms / genetics*,  radiography*
Lymphangiomyoma / genetics*,  radiography*
Middle Aged
Pedigree
Prevalence
Prospective Studies
Pulmonary Alveoli / cytology*,  pathology*
Respiratory Function Tests
Solitary Pulmonary Nodule
Spirometry
Tomography, X-Ray Computed*
Tuberous Sclerosis / complications*,  genetics*
Grant Support
ID/Acronym/Agency:
CA71445/CA/NCI NIH HHS; CA86248/CA/NCI NIH HHS; NS31535/NS/NINDS NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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