A clinical case of late diagnosis of PAP with good response to whole lung lavage

  • Maria Cardone | cardone.maria@virgilio.it Respiratory subintensive care unit, Monaldi Hospital, Naples, Italy.
  • Ludovica Capitelli Department of Clinical Medicine and Surgery, Section of Respiratory Diseases, University of Naples Federico II, Naples, Italy.
  • Francesco Squillante Respiratory subintensive care unit, Monaldi Hospital, Naples, Italy.
  • Filippo Ricciardiello Department of otolaryngology/head and neck surgery, AORN Antonio Cardarelli, Naples, Italy.
  • Marco Bocchetti Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples; Biogem Scarl, Institute of Genetic Research, Laboratory of Molecular and Precision Oncology, Ariano Irpino, Italy.
  • Angela Irene Mirizzi Department of Clinical Medicine and Surgery, Section of Respiratory Diseases, University of Naples Federico II, Naples, Italy.
  • Giuseppe Russo Department of otolaryngology/head and neck surgery, AORN Antonio Cardarelli, Naples, Italy.
  • Francesco Perna Department of Clinical Medicine and Surgery, Section of Respiratory Diseases, University of Naples Federico II, Naples, Italy.

Abstract

Pulmonary Alveolar Proteinosis (PAP) is a rare syndrome characterized by the accumulation of surfactant in alveoli and terminal airways resulting in respiratory failure. PAP comprises part of a spectrum of disorders of surfactant homeostasis (clearance and production). We describe the case of a 54 years-old woman hospitalized in March 2017 with diagnosis of acute hypoxemic respiratory failure secondary to pulmonary interstitial disease. In our case, the patient arrived at our observation after developing a severe respiratory insufficiency although a long term history of respiratory symptoms. This diagnostic delay suggests that alveolar proteinosis should always be considered as a possible diagnosis in patients with dyspnea, cough and crazy paving at HRTC. In spite of this the disease resolved with a cycle of total lung lavage and the symptomatology has improved with the resolution of the radiological picture without any other therapeutic approach.

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Published
2021-01-26
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Section
Case Reports
Keywords:
Pulmonary alveolar proteinosis, acute hypoxemic respiratory failure, whole lung lavage
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How to Cite
Cardone, M., Capitelli, L., Squillante, F., Ricciardiello, F., Bocchetti, M., Mirizzi, A. I., Russo, G., & Perna, F. (2021). A clinical case of late diagnosis of PAP with good response to whole lung lavage. Translational Medicine Reports, 4(1). https://doi.org/10.4081/tmr.9081

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