Pulmonary Alveolar Proteinosis with Severe Respiratory Failure Improved by Segmental Lung Lavage with Fiberoptic Bronchoscopy under General Anesthesia

Intern Med. 2022 Feb 1;61(3):389-393. doi: 10.2169/internalmedicine.7432-21. Epub 2021 Aug 6.

Abstract

Pulmonary alveolar proteinosis (PAP) is a rare disorder in which lipoproteinaceous materials accumulate in the alveolar compartments. A 72-year-old man was diagnosed with autoimmune PAP with severe respiratory failure. We decided to perform segmental lung lavage (SLL) with fiberoptic bronchoscopy under general anesthesia. If improvement was not significant, whole-lung lavage (WLL) would be done. SLL improved the respiratory failure and computed tomography findings. This case showed improvement in not only the area where lavage was done but also the non-lavaged area. SLL with fiberoptic bronchoscopy under general anesthesia might be an appropriate treatment option for patients with severe PAP.

Keywords: fiberoptic bronchoscopy; pulmonary alveolar proteinosis; segmental lung lavage.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anesthesia, General
  • Bronchoalveolar Lavage
  • Bronchoscopy
  • Humans
  • Male
  • Pulmonary Alveolar Proteinosis* / diagnosis
  • Pulmonary Alveolar Proteinosis* / diagnostic imaging
  • Respiratory Insufficiency* / etiology
  • Respiratory Insufficiency* / therapy