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A Case of Secondary Alveolar Proteinosis Requiring Segmental Bronchoalveolar Lavage

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  • Hida Norihito
    Department of Respiratory Medicine, Hitachi Ltd., Hitachinaka General Hospital
  • Yamada Hideyasu
    Department of Respiratory Medicine, Hitachi Ltd., Hitachinaka General Hospital Department of Pulmonary Medicine, University of Tsukuba
  • Mase Kentaro
    Department of Surgery, Hitachi Ltd., Hitachinaka General Hospital
  • Hizawa Nobuyuki
    Department of Pulmonary Medicine, University of Tsukuba

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  • 気管支鏡下での区域洗浄を要した続発性肺胞蛋白症の1例

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Abstract

<p>Background. Pulmonary alveolar proteinosis (PAP) is a rare disease characterized by alveoli filled with PAS-positive surfactants and phospholipids. We herein report an immunosuppressive patient with secondary PAP who was successfully treated by segmental bronchoalveolar lavage (BAL) without any complications. Case. A 54-year-old Japanese man was admitted to our hospital because of a cough during immunosuppressive therapy for Takayasu's arteritis and was hospitalized for suspected acute interstitial pneumonia based on chest X-ray and computed tomography (CT) findings of ground-glass opacities in both lung fields. Broad-spectrum antibiotics, antifungal drugs, and corticosteroids were ineffective, and the diagnosis of PAP was made by a thoracoscopic lung biopsy. Following segmental BAL, his respiratory condition and ground-glass opacity in both lung fields improved with no recurrence. Conclusion. Although whole-lung lavage under general anesthesia is often used as a standard treatment for alveolar proteinosis, even in cases of immunosuppressed hosts with secondary alveolar proteinosis, such as the present patient, segmental BAL is used. A comprehensive approach that includes segmental BAL is necessary.</p>

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