Marked improvement in autoimmune pulmonary alveolar proteinosis with severe hypoxemia in a patient treated with ambroxol: a case report

Journal of Medical Case Reports

Nobuhiko Okada¹  Yusuke Matsumoto¹  Hirofumi Matsuoka¹  Harukazu Yoshimatsu¹  Yujiro Suzuki¹  Koji Tamai¹  Nao Oda¹ 

[1] Department of Respiratory Medicine, Shinko Hospital, 1-4-47, Wakihama-cho, Kobe 651-0072, Chuo-ku, Japan

关键词: Severe hypoxemia;    Ambroxol;    Autoimmune pulmonary alveolar proteinosis;   

Others  :  1204617
DOI  :  10.1186/s13256-015-0588-6

 received in 2014-12-05, accepted in 2015-04-07,  发布年份 2015

【 摘 要 】

Introduction

Pulmonary alveolar proteinosis is characterized by accumulation of surfactant and phospholipids in the pulmonary alveoli. Whole lung lavage is considered the first-line therapy, which requires special techniques. To the best of our knowledge, there have only been limited reports that have demonstrated the effectiveness of ambroxol on a mild case of pulmonary alveolar proteinosis.

Case presentation

A 72-year-old Japanese woman presented to our hospital with a one-year history of productive cough and progressive dyspnea. Her chest computed tomography scan showed a bilateral crazy-paving pattern in both of her lungs. She was diagnosed with autoimmune pulmonary alveolar proteinosis based on bronchoalveolar lavage findings and the presence of serum anti-granulocyte macrophage colony-stimulating factor antibodies. She was severely hypoxemic, so we recommended whole lung lavage or inhaled granulocyte macrophage colony-stimulating factor treatment, which she refused. We initiated treatment with ambroxol and her symptoms markedly improved.

Conclusions

Although whole lung lavage is the first-line therapy for pulmonary alveolar proteinosis, oral ambroxol could be an alternative treatment option, even in patients with severe respiratory compromise.

【 授权许可】

   
2015 Oda et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

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