Nishant Gupta

[Nishant Gupta @NGuptaUC]

@atscommunity A6: In certain cases such as very mild cyst profusion and lack of symptoms it may be appropriate to have a probable diagnosis of LAM. Serial PFT monitoring should be done for these patients. #ATSchat

[Nishant Gupta @NGuptaUC]

@LAMFoundation A6: Renal AMLs and lymphangioleiomyomas can be diagnosed on radiology review in most cases and do not require a biopsy. #ATSchat

[Nishant Gupta @NGuptaUC]

@atscommunity A6: Non-invasive means to confirm LAM include the presence of cysts on HRCT combined with any of the following: Tuberous sclerosis complex, or renal angiomyolipomas, or chylous effusions, or lymphangioleiomyoma, or serum VEGF-D >800pg/ml. #ATSchat

[Nishant Gupta @NGuptaUC]

@atscommunity A6: The diagnosis of LAM should be established in a stepwise manner progressing from least invasive to most invasive. #ATSchat

[Nishant Gupta @NGuptaUC]

@lkbowers333 @LAMFoundation Up to 30% of LAM patients can have low VEGF-D levels (less than 800pg/ml). So a low VEGF-D level doesn't preclude the possibility of #LAM. #ATSchat

[Nishant Gupta @NGuptaUC]

@lkbowers333 @LAMFoundation There is a small risk (less than 5%) of pneumothorax with transbronchial lung biopsy, which may necessitate a hospital stay. #ATSchat

[Nishant Gupta @NGuptaUC]

@lkbowers333 @LAMFoundation Typically transbronchial lung biopsy can be done as an outpatient under moderate (twilight zone) sedation, and most patients are home the same day with no hospital stay required. #ATSchat

[Nishant Gupta @NGuptaUC]

@racheldotbaker Increased provider education through efforts such as these guidelines #ATSchat
Nationwide network of clinics dedicated to rare lung diseases such as the #LAM clinic network

[Nishant Gupta @NGuptaUC]

@atscommunity A4: Certain features suggestive of disease burden such as impaired diffusion capacity can predict a higher yield of transbronchial lung biopsy. #ATSchat

[Nishant Gupta @NGuptaUC]

@atscommunity A4: Transbronchial lung biopsy help make the diagnosis of LAM in greater than 50% of cases. Expert pathology review is critical in these cases. #ATSchat

[Nishant Gupta @NGuptaUC]

@atscommunity A3: With the high burden of pneumothoraces in LAM, the priority should be treatment of pneumothorax and prevention of future events with pleurodesis. #ATSchat

[Nishant Gupta @NGuptaUC]

@atscommunity A3: Prior pleurodesis is not a contraindication to future lung transplant.#ATSchat

[Nishant Gupta @NGuptaUC]

@atscommunity A2: Pleurodesis should be offered to LAM patients following their first pneumothorax rather than waiting for a recurrent event. #ATSchat