Whole Lung Lavage: Treating Pulmonary Alveolar Proteinosis at the Time of COVID Pandemic

Authors

Katherine Jean Powers
Vasanthi Avadhanula
Purvesh R Patel
Pralay Kumar Sarkar
Pedro Piedra
Neda Zarrin-Khameh

Publication Date

1-1-2022

Journal

Respiratory Medicine Case Reports

DOI

10.1016/j.rmcr.2022.101707

PMID

35854794

PMCID

PMC9281412

PubMedCentral® Posted Date

7-14-2022

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Pulmonary alveolar proteinosis, COVID-19, Whole pulmonary lavage, Viral load

Abstract

Pulmonary alveolar proteinosis (PAP) is a rare syndrome due to increased production or decreased clearance of surfactant in alveoli and terminal bronchi that cause hypoxemic respiratory insufficiency. Here we present a patient with PAP whose disease was exacerbated by superimposed COVID-19 pneumonia. He underwent whole lung lavage (WLL). Evaluation of the viral count of the first and the last lavage of the left lung showed viral load in the alveolar space dropped by approximately 10-folds, however the magnitude of the viral load was substantial in both lavage samples. Whole pulmonary lavage may be used as a treatment option on patients with PAP even when the disease is exacerbated by COVID-19 pneumonia.