Lymphangioleiomyomatosis Showing the Development of Mycobacterium abscessus subsp. massiliense Infection during Sirolimus Therapy

• Published in: Internal Medicine Vol. 63; no. 14; pp. 2043 - 2047
• Main Authors: Yanagisawa, Atsushi, Takimoto, Takayuki, Kurahara, Yu, Tsuyuguchi, Kazunari, Yoshida, Shiomi, Hirose, Masaki, Inoue, Yoshikazu, Arai, Toru
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 15.07.2024; Japan Science and Technology Agency
• Subjects: Anti-Bacterial Agents - adverse effects; Anti-Bacterial Agents - therapeutic use; Female; Humans; Lung diseases; Lung transplantation; Lung Transplantation - adverse effects; lymphangioleiomyomatosis; Lymphangioleiomyomatosis - diagnosis; Lymphangioleiomyomatosis - drug therapy; Middle Aged; Mycobacterium abscessus; Mycobacterium abscessus - isolation & purification; Mycobacterium abscessus species; Mycobacterium Infections, Nontuberculous - diagnosis; Mycobacterium Infections, Nontuberculous - drug therapy; Mycobacterium Infections, Nontuberculous - etiology; nontuberculous mycobacterial pulmonary disease; Rapamycin; sirolimus; Sirolimus - adverse effects; Sirolimus - therapeutic use; Mycobacterium abscessus species; lymphangioleiomyomatosis; nontuberculous mycobacterial pulmonary disease; sirolimus
• ISSN: 0918-2918; 1349-7235; 1349-7235
• DOI: 10.2169/internalmedicine.2847-23

Among nontuberculous mycobacterial pulmonary diseases (NTM-PDs), Mycobacterium abscessus species pulmonary disease (MABS-PD) is one of the most severe and intractable infections. We herein report a 45-year-old woman with advanced lymphangioleiomyomatosis (LAM) who developed MABS-PD while undergoing sirolimus therapy. MABS-PD was immediately controlled using antibiotic therapy, although the patient's lung transplant registration was significantly delayed. To our knowledge, this is the first case report on the development of NTM-PD in a patient with LAM before lung transplantation. This case suggests that the early diagnosis and optimal treatment of NTM-PD are crucial in patients with advanced LAM.