A case of secondary pulmonary alveolar proteinosis during glucocorticoid therapy for interstitial pneumonia complicated by HTLV-1 carrier
Tetsuo Fujitaa,b Yasushi Tanimotoc Akihiko Taniguchic Daisuke Nojimac Yoshihiro Mikib Kazuhiro Tomitab Hidenori Nakamurab
a Department of Respiratory Medicine, Chiba University School of Medicine
b Department of Respiratory Medicine, Seirei Hamamatsu General Hospital
c Department of Respiratory Medicine, Okayama University School of Medicine
A 44-year-old man with HTLV-1 carrier was admitted to our hospital because of persistent cough and presence of ground-glass opacities in the lower fields of both lungs. We had diagnosed him with interstitial lung disease because of the findings of a chest CT scan and a bronchoalveolar lavage fluid analysis. Although glucocorticoid therapy was started, pulmonary aspergillosis was complicated, and his respiratory failure has deteriorated in parallel with the worsening in lung opacity. After reevaluating his clinical course, chest CT scan findings, and a PAS-stained specimen obtained by transbronchial lung biopsy, we have diagnosed his disease as pulmonary alveolar proteinosis. We have treated him with whole-lung lavage under general anesthesia. These treatments were effective for his respiratory failure and radiographic findings.
Pulmonary alveolar proteinosis HTLV-1 associated bronchiolo-alveolar disorder Whole lung lavage Pulmonary aspergillosis
Received 1 Jun 2011 / Accepted 26 Oct 2011
AJRS, 1(2): 129-134, 2012