Successful pregnancy in a severely hypoxemic patient with pulmonary alveolar proteinosis

Abstract

Pulmonary alveolar proteinosis (PAP) is a rare disorder characterized by abnormal accumulation of a lipoproteinaceous material in the alveoli, which may lead to respiratory failure and has an associated high risk for infections. The mainstay treatment for PAP is whole lung lavage. A pregnant woman, previously diagnosed with primary PAP, the most common form of PAP, was admitted with dyspnea and worsening respiratory function. In one month period, a wholelung bronchopulmonary lavage was performed twice, with clinical and functional improvement. Pregnancy was carried to term and a healthy baby was delivered.The mechanisms of respiratory impairment are discussed as well as treatment options and response.

Pulmonary Alveolar Proteinosis and Pregnancy: A Review of the Literature and Case Presentation

“…The indication of therapy must be considered by a multidisciplinary team including internal medicine specialists, anesthesiologists, obstetricians, fetal medicine specialists, and neonatologists. So far in the literature, there are few cases of WLL in pregnancy described, and mainly before 34 weeks gestation, as shown in Table 3 [ 12 , 13 , 14 , 15 ]. Among those cases, all but one experienced the exacerbation of the disease during pregnancy [ 14 ].…”