Welcome to Cleveland Clinic Online Health Chats

Get answers to your health questions and concerns. It's easy to be part of our live chat events, led by Cleveland Clinic physicians and health professionals.

Rare Lung Diseases
Wednesday, January 17, 2018 - 12 Noon (Eastern Time)

Sign up for this chat today.Register Now

Click Join Chat to join the chat in progress.You will be asked to login if you aren't already logged in.Join Chat

Daniel Culver, DO

  • Director of the Interstitial Lung Disease Program

Robert Kotloff, MD

  • Chairman of the Department of Pulmonary Medicine

Joseph Parambil, MD

  • Director of the HHT Center of Excellence

Lymphangioleiomyomatosis (LAM) is a lung disease caused by the abnormal growth of smooth muscle cells that leads to blockage of the bronchial tubes and lymphatic vessels, and the formation of holes or cysts in the lung. LAM almost exclusively affects women. Women who have the disease are usually diagnosed between the ages of 20 and 40.

Hereditary hemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome, is a rare genetic disorder that affects how blood vessels are formed. The blood vessels that form incorrectly are called telangiectases. These spots are prone to breaking open and bleeding. People with HHT often have nosebleeds (epistaxis) when younger.

Pulmonary alveolar proteinosis (PAP) is a rare lung disease characterized by the accumulation of protein and lipid material, called surfactant, within the lung air sacs or alveoli. In PAP, the alveoli (air sacs in the lungs) become flooded with more surfactant than normal. The alveoli absorb oxygen from the air into the blood. To do this, the alveoli are lined by a special liquid called surfactant. Surfactant is made up of proteins, lipids and other chemicals, and serves to keep airsacs open to capture oxygen so that the blood can transport it from the lung to the rest of the body.

Take advantage of this opportunity to speak with our pulmonary experts in these rare lung diseases. Daniel Culver, DO, is the director of the Interstitial Lung Disease Program. Robert Kotloff, MD, is chairman of the Department of Pulmonary Medicine. Joseph Parambil, MD, is the director of the HHT Center of Excellence.

About the Speakers
Daniel Culver, DO, is director of the Interstitial Lung Disease Program in the Department of Pulmonary, Medicine at Cleveland Clinic's main campus. He holds joint appointments in the Department of Critical Care and Department of Pathobiology. His clinical interests include interstitial lung diseases, sarcoidosis, pulmonary alveolar proteinosis, and critical care.

Dr. Culver earned his doctor of osteopathic medicine degree at the Ohio University College of Osteopathic Medicine in Athens, Ohio. After medical school, he did an osteopathic rotating internship at Meridia SoutePointe Hospital. He completed his residency in internal medicine and a fellowship in pulmonary and critical care medicine at Cleveland Clinic.


Robert Kotloff, MD, is chairman of the Department of Pulmonary Medicine at the Cleveland Clinic. He has worked in the field of lung transplantation for the past 26 years and has extensive clinical experience in the evaluation of transplant candidates and in the care of transplant recipients.

In addition to his involvement in lung transplantation, Dr. Kotloff has special expertise in the evaluation and management of patients with lymphangioleiomyomatosis (LAM) and other cystic lung diseases. He also maintains an active interest in general pulmonary medicine and, in particular, in evaluating patients with complex pulmonary disorders.


Joseph Parambil, MD, is director of the HHT Center of Excellence and a staff physician in the Department of Pulmonary, Allergy and Critical Care Medicine. He is also Assistant Professor of Medicine at Cleveland Clinic’s Lerner College of Medicine.

He earned his medical degree from Semmelweis Medical University in Budapest, Hungary. He completed a surgical internship at Frankford Hospital in Philadelphia, PA. He completed an internal medicine residency at Henry Ford Hospital in Detroit, Mich., as well as a Fellowship in pulmonary and critical care medicine at Mayo Clinic in Rochester, Minn.

He is certified by the American Board of Internal Medicine with additional specialty certification in pulmonary medicine and critical care medicine.

This Health Chat is currently open to allow you to submit questions. We will try to answer as many questions as possible during the chat. Please create an account to attend the chat and submit your questions.