Tabriz University of Medical Sciences About    Newsletter    Contact Us    Create Account    Log in  
Journal of Analytical Research in Clinical Medicine
   eISSN: 2345-4970  
Services
Export citation
EndNote
Reference Manager
BibTeX
Medlars
Refworks
Mendeley

Cite by
Google Scholar



Article History
Submitted: 17 May 2017
Accepted: 21 Oct 2017
First published online: 21 Oct 2017

Article Access Statistics
Abstract Page Views: 15
PDF Downloads: 76
Full Text Views: 0

J Anal Res Clin Med. 2017;5(4):141-145 doi: 10.15171/jarcm.2017.027

Pulmonary alveolar proteinosis, unusual infiltrative lung disease, the dilemma for physicians: A case report and literature review

Case Report

Ali Ghavidel 1 *

1 Liver and Gastrointestinal Diseases Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran



Abstract
Introduction: Pulmonary alveolar proteinosis (PAP) is a diffuse pulmonary disease characterized by the intra-alveolar accumulation of formless, proteinaceous material. Lipids and proteins materials with specific staining appearance in the alveoli impair pulmonary gas transfer in PAP. The severity of this condition ranges from an asymptomatic clinical presentation to respiratory failure and death. PAP is an extremely rare disorder, occurring worldwide with an estimated prevalence of 0.1 per 100000 individuals. Although the pathogenesis of PAP has remained unknown, most investigators have considered this condition to be caused by the impaired clearance of lipids and surfactant proteins from the airspaces. These functions are known to be performed by alveolar macrophages and type 2 epithelial cells. It is likely that granulocyte macrophage-colony stimulating factor (GM-CSF) dysfunction on macrophages is responsible for PAP. Primarily, in most adult patients with PAP, antibodies against GM-CSF have been observed with dysfunction of macrophages. Secondly, alveolar macrophage dysfunction plays a role in the impaired secretion of surfactant in this disease. It has been noted that both impaired secretion of surfactant and impaired phagocytosis are responsible for disease pathogenesis. Case Report: A 40-year-old man who had suffered from a cough with sputum for more than 2 years, with no associated fever, referred to our clinic. He had been diagnosed with pneumonia and treated unsuccessfully with antibiotics. His past medical history showed that he had a chronic history of a cough, easy fatigability and shortness of breath upon mild exertion. Computed tomography (CT) imaging of the chest revealed bilateral diffuse reticulonodular opacities and a crazy-paving pattern, which was suggestive of alveolar proteinosis. Conclusion: PAP is a generalized pulmonary disorder caused by the collection of formless, proteinaceous material with specific staining appearance in the alveolus.





Comments
First name  
Last name  
Email address  
Comments  
Security code



This Article
PDF

Google Scholar
Articles by Ghavidel A

PubMed
Articles by Ghavidel A



Share this article!
© 2017 Tabriz University of Medical Sciences; unless otherwise stated.

Press Manuscript Online. Powered by MAADRAYAN