Bai H, Meng ZR, Ying BW, Chen XR. Pulmonary alveolar proteinosis complicated with tuberculosis: A case report. World J Clin Cases 2021; 9(17): 4400-4407 [PMID: 34141807 DOI: 10.12998/wjcc.v9.i17.4400]
Corresponding Author of This Article
Xue-Rong Chen, PhD, Chief Doctor, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu 610041, Sichuan Province, China. xuerongchenchen@163.com
Research Domain of This Article
Respiratory System
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jun 16, 2021; 9(17): 4400-4407 Published online Jun 16, 2021. doi: 10.12998/wjcc.v9.i17.4400
Pulmonary alveolar proteinosis complicated with tuberculosis: A case report
Hao Bai, Zi-Rui Meng, Bin-Wu Ying, Xue-Rong Chen
Hao Bai, Zi-Rui Meng, Bin-Wu Ying, Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Xue-Rong Chen, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Bai H and Meng ZR collected and analyzed the patient data, and were major contributors in writing the manuscript; Chen XR and Ying BW interpreted the patient data; all authors read and approved the final manuscript.
Supported bythe National Science and Technology Major Project of the Ministry of Science and Technology of China, No. 2018ZX10715-003.
Informed consent statement: Case report analysis used anonymous data and unidentifiable images that were obtained after the patient agreed to treatment with written consent.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xue-Rong Chen, PhD, Chief Doctor, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu 610041, Sichuan Province, China. xuerongchenchen@163.com
Received: February 1, 2021 Peer-review started: February 1, 2021 First decision: February 25, 2021 Revised: March 12, 2021 Accepted: April 8, 2021 Article in press: April 8, 2021 Published online: June 16, 2021 Processing time: 113 Days and 18.5 Hours
Abstract
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.
Core Tip: Pulmonary alveolar proteinosis (PAP) complicated with tuberculosis is a rare clinical situation. 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. Bronchoalveolar lavage did not induce the dissemination of tuberculosis because anti-tuberculosis drugs were used immediately.
