© 2008 American Thoracic Society
S-LAM in Men: Is Pulmonary Function Different from That Seen in Women?To the Editor:In their case report, Schiavina and colleagues (1) described a pathologically proven case of sporadic lymphangioleiomyomatosis (S-LAM) in a man. The report would have been more complete if it had included physiologic data describing the patient's pulmonary function. Such data are particularly important to determine any difference in the abnormalities expected in women with LAM and their response to treatment. The pulmonary function pattern in women with LAM is well described (2) and is generally obstructive in nature, although mixed restrictive and obstructive findings may occur as well. Pulmonary mechanics studies have isolated the obstructive lesion to the airway as opposed to loss of elastic recoil (3). In addition, acute bronchoreactivity to β-agonists is unusual in patients with severe disease (4). Specific improvement in these physiologic abnormalities is necessary to determine response to treatment. In this case, "a decision was made based on the clinicians' judgment ... to use hormonal manipulation therapy" (1). The patient was said to be "clinically and functionally stable" (1). Generally, the clinical response to hormonal therapy is limited (5). Was this case different? If so, what sort of physiologic variables were measured and which ones were stable or improved? I am very interested in this unique case but believe that the lack of physiologic data lessens the value of this report. I look forward to the authors' providing additional information that will enhance the body of literature on this condition, which is even rarer in men than in women.
Mayo Clinic FOOTNOTES Conflict of Interest Statement: C.D.B. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript. REFERENCES
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