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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...

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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
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author Kawana, Shinichi
Miyoshi, Kentaroh
Tanaka, Shin
Sugimoto, Seiichiro
Shimizu, Dai
Matsubara, Kei
Okazaki, Mikio
Hattori, Noboru
Toyooka, Shinichi
author_facet Kawana, Shinichi
Miyoshi, Kentaroh
Tanaka, Shin
Sugimoto, Seiichiro
Shimizu, Dai
Matsubara, Kei
Okazaki, Mikio
Hattori, Noboru
Toyooka, Shinichi
author_sort Kawana, Shinichi
collection PubMed
description 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.
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spelling pubmed-102038032023-05-24 Pulmonary alveolar proteinosis after lung transplantation: Two case reports and literature review Kawana, Shinichi Miyoshi, Kentaroh Tanaka, Shin Sugimoto, Seiichiro Shimizu, Dai Matsubara, Kei Okazaki, Mikio Hattori, Noboru Toyooka, Shinichi Respirol Case Rep Case Reports 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. John Wiley & Sons, Ltd 2023-05-23 /pmc/articles/PMC10203803/ /pubmed/37229297 http://dx.doi.org/10.1002/rcr2.1160 Text en © 2023 The Authors. Respirology Case Reports published by John Wiley & Sons Australia, Ltd on behalf of The Asian Pacific Society of Respirology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Case Reports
Kawana, Shinichi
Miyoshi, Kentaroh
Tanaka, Shin
Sugimoto, Seiichiro
Shimizu, Dai
Matsubara, Kei
Okazaki, Mikio
Hattori, Noboru
Toyooka, Shinichi
Pulmonary alveolar proteinosis after lung transplantation: Two case reports and literature review
title Pulmonary alveolar proteinosis after lung transplantation: Two case reports and literature review
title_full Pulmonary alveolar proteinosis after lung transplantation: Two case reports and literature review
title_fullStr Pulmonary alveolar proteinosis after lung transplantation: Two case reports and literature review
title_full_unstemmed Pulmonary alveolar proteinosis after lung transplantation: Two case reports and literature review
title_short Pulmonary alveolar proteinosis after lung transplantation: Two case reports and literature review
title_sort pulmonary alveolar proteinosis after lung transplantation: two case reports and literature review
topic Case Reports
url 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
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