[Pulmonary alveolar proteinosis. Report of a case].

Autor: Morales-Gutiérrez JE; Universidad Juárez Autónoma de Tabasco, Escuela de Medicina, División Académica de Ciencias de la Salud. Villahermosa, Tabasco, México., Silva-Medina MA; Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades 'Dr. Antonio Fraga Mouret'. Servicio de Medicina Interna. Ciudad de México, México., Cuadros-Moreno J; Instituto Mexicano del Seguro Social, Coordinación de Educación en Salud, División de Innovación. Ciudad de México, México., Cuevas-Bulnes JJ; Centro de Radiodiagnóstico Computarizado Médico de Tabasco S.A. de C.V., Servicio de Neumología Pediátrica. Villahermosa, Tabasco, México., Medina-García G; Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades 'Dr. Antonio Fraga Mouret', Unidad de Investigación en Medicina Traslacional en Enfermedades Hemato-oncológicas. Ciudad de México, México., Espinoza JL; Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades 'Dr. Antonio Fraga Mouret', Servicio de Neumología. Ciudad de México, México., Reyes-Navarro GV; Benemérita Universidad Autónoma de Puebla, Campus Puebla, Facultad de Medicina. Puebla, Puebla, México., Vera-Lastra OL; Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades 'Dr. Antonio Fraga Mouret', Departamento de Medicina Interna. Ciudad de México, México.
Jazyk: Spanish; Castilian
Zdroj: Revista medica del Instituto Mexicano del Seguro Social [Rev Med Inst Mex Seguro Soc] 2021 Aug 02; Vol. 59 (4), pp. 347-351. Date of Electronic Publication: 2021 Aug 02.
Abstrakt: Background: The pulmonary alveolar proteinosis (PAP) is characterized by the accumulation of lipoprotein material in the alveoli. It is classified as primary, secondary and congenital. The primary form, of autoimmune origin, is characterized by antibodies against granulocyte-macrophage colony stimulating factor (GM-CSF). The aim of this article is to present a case of PAP with adequate response to treatment with bronchoalveolar lavage (BAL) and GM-CSF.
Clinical Case: A 28-year-old female patient who started with mild to moderate effort dyspnea, distal cyanosis and lower respiratory tract infection. We found restrictive pattern respiratory function tests, chest X-ray with bilateral nodular reticulum pattern and high-resolution tomography with ground glass image and bronchiectasis, besides video bronchoscopy with inflammatory process. The open biopsy revealed data of alveolar proteinaceous material and mononuclear infiltrate. Treatment was given with BAL and GM-CSF which was suspended by dermal reaction. The patient had a satisfactory evolution and is currently asymptomatic.
Conclusion: The present case had clinical, imaging and histological manifestations for the diagnosis of autoimmune PAP with a satisfactory response to treatment. Although PAP is a low prevalence entity, the diagnosis and therapeutic options must be taken into account, including BAL and GM-CSF, since this factor is required for surfactant factor homeostasis.
(© 2021 Instituto Mexicano del Seguro Social.)
Databáze: MEDLINE
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