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

Abstract

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.

• Authors: Nao Oda, Koji Tamai, Yujiro Suzuki, Harukazu Yoshimatsu, Hirofumi Matsuoka, Yusuke Matsumoto, Nobuhiko Okada
• Journal: Journal of medical case reports (J Med Case Rep) Vol. 9 Pg. 100 (May 06 2015) ISSN: 1752-1947 [Electronic] England
• PMID: 25943363 (Publication Type: Case Reports, Journal Article)

Chemical References

• Expectorants
• Ambroxol
• Granulocyte-Macrophage Colony-Stimulating Factor

Topics

• Aged
• Ambroxol (therapeutic use)
• Autoimmune Diseases (drug therapy)
• Expectorants (therapeutic use)
• Female
• Granulocyte-Macrophage Colony-Stimulating Factor (administration & dosage)
• Humans
• Hypoxia (drug therapy)
• Lung Diseases (diagnostic imaging)
• Pulmonary Alveolar Proteinosis (drug therapy)
• Tomography, X-Ray Computed