Pulmonary alveolar proteinosis and successful therapy with combined lavage procedures: Case reports

Firat,Nalan Demir; Ciledag,Aydin; Kabalak,Pinar Akin; Karnak,Demet; Meco,Basak Ceyda; Alanoglu,Zekeriyya; Alkis,Neslihan

doi:10.3892/etm.2011.230

May-June 2011 Volume 2 Issue 3

Full Size Image

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

An International Open Access Journal Devoted to General Medicine.

May-June 2011 Volume 2 Issue 3

Full Size Image

Case Report

Pulmonary alveolar proteinosis and successful therapy with combined lavage procedures: Case reports

Authors:
- Nalan Demir Firat
- Aydin Ciledag
- Pinar Akin Kabalak
- Demet Karnak
- Basak Ceyda Meco
- Zekeriyya Alanoglu
- Neslihan Alkis
View Affiliations / Copyright

Affiliations: Department of Chest Diseases, Ankara University School of Medicine, 06100 Cebeci, Ankara, Turkey, Department of , Ankara University School of Medicine, 06100 Cebeci, Ankara, Turkey, Department of Anesthesiology, Ankara University School of Medicine, 06100 Cebeci, Ankara, Turkey
Pages: 569-573
|
Published online on: March 18, 2011

https://doi.org/10.3892/etm.2011.230
Expand metrics +

Abstract

Pulmonary alveolar proteinosis (PAP) is a rare disease characterized by the accumulation of lipoproteinaceous material within alveolar spaces. Whole-lung lavage (WLL) has been the most common therapeutic intervention for this disorder. However, patients presenting with PAP are usually hypoxemic or in poor clinical condition, and WLL may be impossible to perform. In such cases, multiple segmental lavage (MSL) may be advocated as a first-choice therapy prior to WLL. Herein, we present two cases with idiopathic PAP treated successfully with both lavage techniques consecutively. After the MSL procedure, WLL was performed, and both patients showed a marked clinical and physiologic improvement. Therefore, for patients who are not good candidates for general anesthesia, we recommend MSL (or ‘prewash’) before WLL to produce an increase in the blood oxygen level for long-duration general anesthesia. In the surgical room, close monitoring and repositioning of the patient as well as maintenance and inspection of the correct tube position, and manual chest wall percussion are extremely important for the safety and success of the procedure.

View Figures

View References

1.	Rosen SH, Castleman B and Liebow AA: Pulmonary alveolar proteinosis. N Engl J Med. 258:1123–1142. 1958. View Article : Google Scholar : PubMed/NCBI
2.	Ramirez J, Nyka W and McLaughlin J: Pulmonary alveolar proteinosis: diagnostic techniques and observations. N Engl J Med. 268:165–171. 1963. View Article : Google Scholar
3.	Cheng SL, Chang HT, Lau HP, Lee LN and Yang PC: Pulmonary alveolar proteinosis: treatment by bronchofiberscopic lobar lavage. Chest. 122:1480–1485. 2002. View Article : Google Scholar : PubMed/NCBI
4.	Beccaria M, Luisetti M, Rodi G, et al: Long-term durable benefit after whole lung lavage in pulmonary alveolar proteinosis. Eur Respir J. 23:526–531. 2004. View Article : Google Scholar : PubMed/NCBI
5.	Ben-Dov I, Kishinevski Y, Roznman J, et al: Pulmonary alveolar proteinosis in Israel: ethnic clustering. Isr Med Assoc J. 1:75–78. 1999.PubMed/NCBI
6.	Ioachimescu OC and Kavuru MS: Pulmonary alveolar proteinosis. Chron Respir Dis. 3:149–159. 2006. View Article : Google Scholar : PubMed/NCBI
7.	Wang BM, Stern EJ, Schmidt RA and Pierson DJ: Diagnosing pulmonary alveolar proteinosis: a review and an update. Chest. 111:460–466. 1997. View Article : Google Scholar : PubMed/NCBI
8.	Davidson JM and Macleod WM: Pulmonary alveolar proteinosis. Br J Dis Chest. 463:13–28. 1969. View Article : Google Scholar
9.	Larson RK and Gordinier R: Pulmonary alveolar proteinosis: report of six cases, review of the literature and formulation of a new theory. Ann Intern Med. 62:292–312. 1965. View Article : Google Scholar : PubMed/NCBI
10.	Bala RM and Snidal DP: Pulmonary alveolar proteinosis. A case report and review of the literature. Dis Chest. 49:643–651. 1966. View Article : Google Scholar : PubMed/NCBI
11.	Pallav LS, Hansell D, Lawson PR, Reid KB and Morgan C: Pulmonary alveolar proteinosis: clinical aspects and current concepts on pathogenesis. Thorax. 55:67–77. 2000. View Article : Google Scholar : PubMed/NCBI
12.	Kavuru MS, Sullivan EJ, Piccin R, Thomassen MJ and Stoller JK: Exogenous granulocyte-macrophage colony-stimulating factor administration for pulmonary alveolar proteinosis. Am J Respir Crit Care Med. 161:1143–1148. 2000. View Article : Google Scholar
13.	Seymour JF, Dunn AR, Vincent JM, Persneill JJ and Pain MC: Efficacy of granulocyte-macrophage colony-stimulating factor in acquired alveolar proteinosis. N Engl J Med. 335:1924–1925. 1996. View Article : Google Scholar : PubMed/NCBI
14.	Seymour JF, Persneill JJ, Schoch OD, et al: Therapeutic efficacy of granulocyte-macrophage colony-stimulating factor in patients with idiopathic acquired alveolar proteinosis. Am J Respir Crit Care Med. 163:524–531. 2001. View Article : Google Scholar
15.	Trapnell BC, Nakata K and Kavuru MS: Pulmonary alveolar proteinosis syndrome. Textbook of Respiratory Medicine. 5th edition. Mason RJ, Broaddus VC, Martin TR, King TE, Schraufnagel DE, Murray JF and Nadel JA: Saunders Elsevier; Philadelphia: pp. 1516–1536. 2010
16.	Prakash UB, Barham SS, Carpenter HA, Dines DE and Marsh HM: Pulmonary alveolar phospholipoproteinosis: experience with 34 cases and a review. Mayo Clin Proc. 62:499–518. 1987. View Article : Google Scholar : PubMed/NCBI
17.	Edis EC, Tabakoglu E, Caglar T, Hatipoglu ON, Cevirme L and Alagol A: Treatment of a primary pulmonary alveolar proteinosis case with severe hypoxaemia by using segmental lavage technique. Ann Acad Med Singapore. 36:871–872. 2007.PubMed/NCBI
18.	Perez A and Rogers RM: Enhanced alveolar clearance with chest percussion therapy and positional changes during whole-lung lavage for alveolar proteinosis. Chest. 125:2351–2356. 2004. View Article : Google Scholar
19.	Hammon WE, McCaffree DR and Cucchiara AJ: A comparison of manual to mechanical chest percussion for clearance of alveolar material in patients with pulmonary alveolar proteinosis (phospholipidosis). Chest. 103:1409–1412. 1993. View Article : Google Scholar
20.	Webb ST, Evans AJ, Varley AJ and Klein AA: Anaesthesia for serial whole-lung lavage in a patient with severe pulmonary alveolar proteinosis: a case report. J Med Case Reports. 2:3602008. View Article : Google Scholar : PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Pulmonary alveolar proteinosis and successful therapy with combined lavage procedures: Case reports

This article is mentioned in:

Abstract

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Figure 6

Figure 7

Figure 8

Figure 9

Related Articles