Whole lung lavage: Treating pulmonary alveolar proteinosis at the time of COVID pandemic

Katherine Jean Powers; Vasanthi Avadhanula; Purvesh R Patel; Pralay Kumar Sarkar; Pedro Piedra; Neda Zarrin-Khameh

doi:10.1016/j.rmcr.2022.101707

Whole lung lavage: Treating pulmonary alveolar proteinosis at the time of COVID pandemic

Respir Med Case Rep. 2022:39:101707. doi: 10.1016/j.rmcr.2022.101707. Epub 2022 Jul 14.

Authors

Katherine Jean Powers¹, Vasanthi Avadhanula², Purvesh R Patel³, Pralay Kumar Sarkar³, Pedro Piedra², Neda Zarrin-Khameh^{4

5}

Affiliations

¹ Department of Anesthesiology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
² Department of Molecular Virology & Microbiology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
³ Department of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
⁴ Department of Pathology & Immunology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
⁵ Ben Taub Hospital, 1504 Taub Loop, Houston, TX, 77030, USA.

Abstract

Pulmonary alveolar proteinosis (PAP) is a rare syndrome due to increased production or decreased clearance of surfactant in alveoli and terminal bronchi that cause hypoxemic respiratory insufficiency. Here we present a patient with PAP whose disease was exacerbated by superimposed COVID-19 pneumonia. He underwent whole lung lavage (WLL). Evaluation of the viral count of the first and the last lavage of the left lung showed viral load in the alveolar space dropped by approximately 10-folds, however the magnitude of the viral load was substantial in both lavage samples. Whole pulmonary lavage may be used as a treatment option on patients with PAP even when the disease is exacerbated by COVID-19 pneumonia.

Keywords: COVID-19; Pulmonary alveolar proteinosis; Viral load; Whole pulmonary lavage.

Publication types

Case Reports