{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T12:31:35Z","timestamp":1768998695433,"version":"3.49.0"},"reference-count":23,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,12,2]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>Lymphangioleiomyomatosis (LAM) is a progressive cystic lung disease which mostly affects premenopausal women and could be exacerbated by pregnancy. Therefore, it is thought that oestrogen plays an important role in LAM pathogenesis. Here, a case of LAM is described in which the first presentation of symptoms occurred during the third trimester of pregnancy. Symptoms included acute onset dyspnoea and chest pain at gestational age of 39 weeks and 2 days. A CT was performed which showed multiple thin-walled cysts and a small pneumothorax. Serum levels of vascular endothelial growth factor-D (VEGF-D) was 1200\u2009pg\/mL. The typical cystic lung changes on chest CT in combination with elevated VEGF-D is diagnostic for LAM. Given the risk of respiratory complications, the decision was made to deliver the baby at a gestational age of 39 weeks and 6 days by a planned caesarean section. Both mother and child were discharged home in good condition.<\/jats:p>","DOI":"10.1136\/bcr-2020-237824","type":"journal-article","created":{"date-parts":[[2021,1,18]],"date-time":"2021-01-18T12:20:00Z","timestamp":1610972400000},"page":"e237824","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Initial presentation of lymphangioleiomyomatosis in third trimester of pregnancy"],"prefix":"10.1136","volume":"14","author":[{"given":"Lily","family":"Alkemade","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology, OLVG, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meike A T","family":"Berghuis","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, OLVG, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bart","family":"Koopman","sequence":"additional","affiliation":[{"name":"Pulmonary Medicine, OLVG, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mari\u00eblle G","family":"van Pampus","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, OLVG, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,1,18]]},"reference":[{"key":"2025082622423162000_14.1.e237824.1","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1177\/030089160409000519","article-title":"Lymphangioleiomyomatosis: a case report and review of the literature","volume":"90","author":"Bearz","year":"2004","journal-title":"Tumori"},{"key":"2025082622423162000_14.1.e237824.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2008.11.007"},{"key":"2025082622423162000_14.1.e237824.3","unstructured":"Factsheets LAM . 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Relation of pulmonary lymphangio- leiomyomatosis 1994:910\u20134.","DOI":"10.1136\/thx.49.9.910"},{"key":"2025082622423162000_14.1.e237824.15","first-page":"63","article-title":"Pregnancy unmasking symptoms of undiagnosed lymphangioleiomyomatosis: case report and review of literature","volume":"26","author":"Khaddour","year":"2019","journal-title":"Respir Med Case Rep"},{"key":"2025082622423162000_14.1.e237824.16","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.ccm.2016.04.002","article-title":"Lymphangioleiomyomatosis","volume":"37","author":"Johnson","year":"2016","journal-title":"Clin Chest Med"},{"key":"2025082622423162000_14.1.e237824.17","doi-asserted-by":"crossref","unstructured":"Seyama K , Kumasaka T , Souma S , et al . Serum of patients with lymphangioleiomyomatosis. 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