ER Medicine Quick Facts
The following medical information is provided as a general resource only. It is not intended to be used for patient education. It does not create any patient-physician relationship and should not be used as a substitute for professional diagnosis and treatment.
Read the LAM CLinical Practice Guidelines
To view the ATS/JRS 2016 LAM Clinical Practice Guidelines, click here.
To view the ATS/JRS 2017 LAM Clinical Practice Guidelines, CLICK HERE.
Continuing Medical Education
Lymphangioleiomyomatosis Evidence Based Practice, a new Continuing Medical Education (CME) Enduring Material activity, is now available through the joint providership of the University of Cincinnati and the RLDC for AMA PRA Category 1 Credits™ (1.00 hours), Non-Physician Attendance (1.00 hours), ABIM MOC Part 2 (1.00 hours). The course reviews the 2016 and 2017 ATS/JRS Clinical Practice Guidelines in addition to sharing clinical pearls from experienced LAM Clinic Directors.
This activity has been designed to meet the educational needs of pulmonologists, obstetricians and gynecologists, emergency room physicians, family medicine physicians, internal medicine physicians, nurse practitioners and physician assistants, and respiratory therapists involved in the management of patients with LAM. Clinicians can take the course and receive continuing education credits at no cost, for both CME and maintenance of certification (MOC).
Jointly provided by the University of Cincinnati and the Rare Lung Disease Consortium,
this activity is supported by an independent educational grant from the UNC Eshelman Institute for Innovation as well as contributions from The LAM Foundation and the Rare Lung Disease Consortium.
To participate in this activity, please visit https://uc.cloud-cme.com/aph.aspx?EID=20754&P=3000&CaseID=2410.
About Lymphangioleiomyomatosis (LAM)
Lymphangioleiomyomatosis (LAM) is a rare lung disease in women that results in diffuse cystic changes in the lung parenchyma. It is associated with recurrent pneumothoraces, chylous pleural effusions, progressive respiratory failure and abdominal tumors, including lymphangiomyomas or angiomyolipomas, which can spontaneously hemorrhage and result in pain, anemia and hypotension.
Here are some insights for treating patients with LAM in the ER:
- Pneumothorax should generally be managed with chest tube drainage followed by pleurodesis on the first event.
- Cystic changes due to LAM are often not apparent on chest X ray. High-resolution CT scanning of the chest is the most definitive imaging test.
- Pleural effusions usually represent chylothorax. This may be verified by thoracentesis and assessment of pleural fluid triglycerides and cholesterol.
- Renal angiomyolipomas may bleed spontaneously producing flank pain, hematuria, hypotension and anemia.
- Lymphangiomyomas may present as low-density abdominal lesions that mimic lymphoma or other malignancies.
- If the patient is to undergo anesthesia, the anesthesiologist should be advised that the patient is at risk for a pneumothorax with positive pressure ventilation.
- RAPAMUNE® (sirolimus) is an FDA approved drug to treat LAM. Special precautions should be taken for patients using sirolimus as it can impair wound healing in the event of urgent surgery. Sirolimus can also produce lung injury, immunosuppression, mouth ulcers, peripheral edema, acne like lesions and elevations of cholesterol.
The ICD 10 Code for LAM is J84.81.
For additional information or for a referral to a LAM specialist, contact The LAM Foundation at 513.777.6889.
This content was created for general informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.