Segmental Bronchoalveolar Lavage Provided a Favorable Clinical Course in a Case of Autoimmune Pulmonary Alveolar Proteinosis

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  • MANABE Takehiko
    Department of Thoracic Surgery, Kitakyushu General Hospital. Kokurakita-ku, Kitakyushu 802-8517 Japan
  • OYAMA Rintaro
    Respiratory Disease Center, Shinkokura Hospital. Kokurakita-ku, Kitakyushu 803-8505 Japan
  • YAMAGUCHI Yudai
    Respiratory Disease Center, Shinkokura Hospital. Kokurakita-ku, Kitakyushu 803-8505 Japan
  • HANAGIRI Takeshi
    Department of Thoracic Surgery, Kitakyushu General Hospital. Kokurakita-ku, Kitakyushu 802-8517 Japan Respiratory Disease Center, Shinkokura Hospital. Kokurakita-ku, Kitakyushu 803-8505 Japan

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  • 気管支鏡下反復肺区域洗浄が奏効した自己免疫性肺胞蛋白症の一例
  • キカンシキョウ カ ハンプク ハイ クイキ センジョウ ガ ソウコウ シタ ジコ メンエキセイ ハイホウタンパクショウ ノ イチレイ

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Abstract

<p>A 49-year-old man was diagnosed with autoimmune pulmonary alveolar proteinosis. Chest computed tomography (CT) showed typical CT findings of pulmonary alveolar proteinosis: thickening of septa with ground-glass opacities in both lung fields. The diagnosis of autoimmune pulmonary alveolar proteinosis (PAP) was based on findings of bronchoalveolar lavage (BAL) fluid with milky appearance and elevated serum titer of anti-granulocyte-macrophage colony-stimulating factor antibody. We decided to perform segmental BAL via bronchoscopy. The surgery was performed under a general anesthesia since the patient had severe hypoxemia and strong cough reflex. Following 3 repeated courses of therapy, his respiratory condition and the ground-glass opacity in both lung fields improved remarkably, with no recurrence in 3 years. There are only a few published case reports in the world of the usefulness of segmental BAL under general anesthesia for PAP. We consider that segmental BAL is a useful therapeutic method for PAP in cases with severe hypoxemia, such as the present patient.</p>

Journal

  • Journal of UOEH

    Journal of UOEH 44 (1), 83-89, 2022-03-01

    The University of Occupational and Environmental Health, Japan

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