Cargando…

Pulmonary alveolar proteinosis after lung transplantation: Two case reports and literature review

Pulmonary alveolar proteinosis (PAP) affecting transplanted lungs is not well recognized. Herein, we report two cases of PAP after lung transplantation (LTx). The first case was a 4‐year‐old boy with hereditary pulmonary fibrosis who underwent bilateral LTx and presented with respiratory distress on...

Descripción completa

Detalles Bibliográficos
Autores principales: Kawana, Shinichi, Miyoshi, Kentaroh, Tanaka, Shin, Sugimoto, Seiichiro, Shimizu, Dai, Matsubara, Kei, Okazaki, Mikio, Hattori, Noboru, Toyooka, Shinichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Ltd 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10203803/
https://www.ncbi.nlm.nih.gov/pubmed/37229297
http://dx.doi.org/10.1002/rcr2.1160
Descripción
Sumario:Pulmonary alveolar proteinosis (PAP) affecting transplanted lungs is not well recognized. Herein, we report two cases of PAP after lung transplantation (LTx). The first case was a 4‐year‐old boy with hereditary pulmonary fibrosis who underwent bilateral LTx and presented with respiratory distress on postoperative day (POD) 23. He was initially treated for acute rejection, died due to infection on POD 248, and was diagnosed with PAP at autopsy. The second case involved a 52‐year‐old man with idiopathic pulmonary fibrosis who underwent bilateral LTx. On POD 99, chest computed tomography revealed ground‐glass opacities. Bronchoalveolar lavage and transbronchial biopsy led to a diagnosis of PAP. Follow‐up with immunosuppression tapering resulted in clinical and radiological improvement. PAP after lung transplantation mimics common acute rejection; however, is potentially transient or resolved with tapering immunosuppression, as observed in the second case. Transplant physicians should be aware of this rare complication to avoid misconducting immunosuppressive management.