Milky fluid from the lungs: pulmonary alveolar proteinosis

Nimmatoori, Divya P; Bansal, Saurabh; Singhania, Namrata; Singh, Anil Kumar; Sudigali, Vijay Mohan

doi:10.1007/s11739-020-02484-z

Cited by 1 publication

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“…There are common symptoms of PAP and tuberculosis, which will lead to a missed diagnosis or misdiagnosis. However, cases of PAP complicated with tuberculosis have rarely been well recorded (Table 2 )[ 13 - 23 ]. Empirically, we need to be vigilant about the following signals in PAP patients, which indicate the presence of tuberculosis infection.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary alveolar proteinosis complicated with tuberculosis: A case report

Bai

Meng

Ying

et al. 2021

WJCC

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BACKGROUND Pulmonary alveolar proteinosis (PAP) is a rare lung disease characterized by the accumulation of phospholipoproteinaceous material in the alveoli. Cases of PAP complicated with tuberculosis are much more complex and have rarely been well recorded. CASE SUMMARY We describe a 21-year-old Han Chinese patient with suspicious lung infection associated with mild restrictive ventilatory dysfunction and diffusion reduction. High resolution computed tomography revealed a “crazy-paving” appearance and multiple pulmonary miliary nodules around the bronchi. Bronchoalveolar lavage demonstrated a small amount of periodic acid-Schiff positive proteinaceous materials. A serological test for the presence of a Mycobacterium tuberculosis antibody and an interferon-gamma release assay were both positive. The patient received a standard course of first-line anti-tuberculosis treatment after diagnostic bronchoalveolar lavage. To date, clinical remission has been achieved and maintained for five years. CONCLUSION In summary, the diagnosis of PAP complicated with tuberculosis was supported by a combination of clinical manifestations, imaging, pulmonary function, laboratory examinations, bronchoalveolar lavage, etc . This case highlighted that diagnostic bronchoalveolar lavage in combination with anti-tuberculosis treatment is a safe and effective option for mild PAP patients with tuberculosis.

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Section: Discussionmentioning

confidence: 99%