Resumen

OSEJO-BETANCOURT, Miguel; MORENO-RAMIREZ, Carlos Ernesto  y  CHAPARRO-MUTIZ, Pedro. Whole Lung Lavage Protocol at Hospital Santa Clara of Bogotá: Presentation of a Patient with Resistant Pulmonary Alveolar Proteinosis. Rev. am. med. respir. [online]. 2022, vol.22, n.4, pp.354-364. ISSN 1852-236X.  http://dx.doi.org/10.56538/ramr.lnrd6464.

Pulmonary alveolar proteinosis is a clinical entity characterized by the accumulation of proteinaceous material, rich in surfactant, mediated by reduced clearance by alveolar macrophages. In adult patients, it is commonly associated with autoimmune phenom ena resulting in a deficiency of the granulocyte-macrophage colony stimulating factor, which implies alterations in cell maturation and dysfunction, causing a decrease in surfactant degradation and its accumulation in the alveolar space. Its diagnosis poses a challenge to the clinician, based on the findings of pulmonary function tests and the crazy paving pattern of the high-resolution computed tomography of the chest, and is confirmed by obtaining the proteinaceous material in the bronchoalveolar la vage. Given its rarity, the ideal treatment remains to be elucidated, with whole lung lavage currently being the cornerstone of treatment. We report an anecdotal case of a 41-year-old female patient suffering from pulmonary alveolar proteinosis since 2011, who has required multiple whole lung lavages, with poor response to these, with persistent dyspnea and supplemental oxygen requirement even though she has performed the procedure, but with a progressive tendency towards improvement in the last 2 years. The lavage technique is not completely standardized and its use in Latin America is still limited, which is why we publish the protocol used in the Hospital Santa Clara of Bogotá, Colombia.

Palabras clave : Pulmonary alveolar proteinosis; Pulmonary medicine; Protocol; Whole lung la vage; Rare disease.

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