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Congenital pulmonary lymphangiectasia
Disease definition
A rare developmental disorder involving the lung and characterized by pulmonary subpleural, interlobar, perivascular, and peribronchial lymphatic dilatation.
ORPHA:2414
Classification level: DisorderSummary
Epidemiology
The prevalence is unknown.
Clinical description
Congenital pulmonary lymphangiectasia (PL) presents at birth with severe respiratory distress, tachypnea and cyanosis, with a very high mortality rate at or within a few hours of birth.
Etiology
Most reported cases are sporadic and the etiology is not completely understood. It has been suggested that PL lymphatic channels of the fetal lung do not undergo the normal regression process at 20 weeks of gestation. Secondary PL may be caused by a cardiac lesion.
Diagnostic methods
The diagnostic approach includes obtaining a complete family and obstetric history, conventional radiologic studies, ultrasound and magnetic resonance studies, lymphoscintigraphy, lung functionality tests, lung biopsy, bronchoscopy, and pleural effusion examination.
Differential diagnosis
During the prenatal period, all causes leading to hydrops fetalis should be considered in the diagnosis of PL.
Antenatal diagnosis
Fetal ultrasound evaluation plays a key role in the antenatal diagnosis of PL.
Management and treatment
At birth, mechanical ventilation and pleural drainage are nearly always necessary to obtain a favorable outcome of respiratory distress. Home supplemental oxygen therapy and symptomatic treatment of recurrent cough and wheeze are often necessary during childhood, sometimes associated with prolonged pleural drainage.
Prognosis
Recent advances in intensive neonatal care have changed the previously nearly fatal outcome of PL at birth. Patients affected by PL who survive infancy, present medical problems which are characteristic of chronic lung disease.
A summary on this disease is available in Deutsch (2006) Español (2006) Français (2006) Italiano (2006) Nederlands (2006)
Detailed information
Disease review articles
- Review article
- English (2006) - Orphanet J Rare Dis


Additional information