
Anaesthetic Challenges in Pulmonary Alveolar Proteinosis: A Rare Case Report
Correspondence Address :
Dr. Priyanka Dev,
Associate Professor, Department of Anaesthesiology, NEIGRIHMS, Shillong-793018, Meghalaya, India.
E-mail: priyanka8ap@gmail.com
Pulmonary Alveolar Proteinosis (PAP) is a rare pulmonary disease characterised by the accumulation of surfactant within the alveoli, leading to impaired gas exchange. This case involves a 31-year-old male presenting with shortness of breath. Fine crackles were heard on auscultation, raising the suspicion of alveolar involvement. High-Resolution Computed Tomography (HRCT) of the chest revealed a “crazy paving” pattern in the bilateral lung parenchyma, a hallmark imaging finding in PAP. Histopathological analysis confirmed the diagnosis, showing alveoli filled with granular, eosinophilic, Periodic Acid Schiff (PAS)-positive material, indicative of surfactant accumulation. The patient was scheduled for Whole Lung Lavage (WLL), the standard therapeutic procedure for PAP, under General Anaesthesia (GA). A Double-lumen Endotracheal Tube (DLT) was employed to facilitate isolation of each lung, ensuring effective lavage of the affected lung while maintaining ventilation in the other. This case highlights the importance of a multidisciplinary approach, integrating clinical evaluation, advanced imaging, histopathology and specialised anaesthetic techniques in managing rare conditions like PAP. This comprehensive strategy aims to restore alveolar function and improve the patient’s respiratory status, underscoring the critical role of timely diagnosis and intervention in rare pulmonary disorders.
Bronchopulmonary lavage, Pulmonary surfactant, Single-lung ventilation
DOI: 10.7860/JCDR/2025/76044.20719
Date of Submission: Oct 23, 2024
Date of Peer Review: Nov 27, 2024
Date of Acceptance: Feb 10, 2025
Date of Publishing: Mar 01, 2025
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Oct 25, 2024
• Manual Googling: Jan 08, 2025
• iThenticate Software: Feb 08, 2025 (9%)
ETYMOLOGY: Author Origin
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