Anaesthetic Challenges in Pulmonary Alveolar Proteinosis: A Rare Case Report

Pulmonary Alveolar Proteinosis (PAP) is a rare pulmonary disease characterised by the accumulation of surfactant within the alveoli, leading to impaired gas exchange. This case involves a 31-year-old male presenting with shortness of breath. Fine crackles were heard on auscultation, raising the susp...

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Main Authors: Dasara Nongbet, Priyanka Dev, Vijay Noel Nongpiur, John Muchahary, Pranjal Kalita
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2025-03-01
Series:Journal of Clinical and Diagnostic Research
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Online Access:https://jcdr.net/articles/PDF/20719/76044_CE[Ra1]_F(SS)_QC(AN_SL)_PF1(AG_IS)_PFA(IS)_PB(AG_IS)_PN(IS).pdf
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author Dasara Nongbet
Priyanka Dev
Vijay Noel Nongpiur
John Muchahary
Pranjal Kalita
author_facet Dasara Nongbet
Priyanka Dev
Vijay Noel Nongpiur
John Muchahary
Pranjal Kalita
author_sort Dasara Nongbet
collection DOAJ
description Pulmonary Alveolar Proteinosis (PAP) is a rare pulmonary disease characterised by the accumulation of surfactant within the alveoli, leading to impaired gas exchange. This case involves a 31-year-old male presenting with shortness of breath. Fine crackles were heard on auscultation, raising the suspicion of alveolar involvement. High-Resolution Computed Tomography (HRCT) of the chest revealed a “crazy paving” pattern in the bilateral lung parenchyma, a hallmark imaging finding in PAP. Histopathological analysis confirmed the diagnosis, showing alveoli filled with granular, eosinophilic, Periodic Acid Schiff (PAS)-positive material, indicative of surfactant accumulation. The patient was scheduled for Whole Lung Lavage (WLL), the standard therapeutic procedure for PAP, under General Anaesthesia (GA). A Double-lumen Endotracheal Tube (DLT) was employed to facilitate isolation of each lung, ensuring effective lavage of the affected lung while maintaining ventilation in the other. This case highlights the importance of a multidisciplinary approach, integrating clinical evaluation, advanced imaging, histopathology and specialised anaesthetic techniques in managing rare conditions like PAP. This comprehensive strategy aims to restore alveolar function and improve the patient’s respiratory status, underscoring the critical role of timely diagnosis and intervention in rare pulmonary disorders.
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spelling doaj-art-4ca26944484441bb83ec6d2805f5ec5e2025-08-20T03:08:56ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2025-03-01193010410.7860/JCDR/2025/76044.20719Anaesthetic Challenges in Pulmonary Alveolar Proteinosis: A Rare Case ReportDasara Nongbet0Priyanka Dev1Vijay Noel Nongpiur2John Muchahary3Pranjal Kalita4Senior Resident, Department of Anaesthesiology, NEIGRIHMS, East Khasi Hills, Meghalaya, India.Associate Professor, Department of Anaesthesiology, NEIGRIHMS, Shillong, Meghalaya, India.Assistant Professor, Department of Pulmonary Medicine, NEIGRIHMS, Shillong, Meghalaya, India.Senior Resident, Department of Pulmonary Medicine, NEIGRIHMS, Shillong, Meghalaya, India.Senior Resident, Department of Pathology, NEIGRIHMS, Shillong, Meghalaya, India.Pulmonary Alveolar Proteinosis (PAP) is a rare pulmonary disease characterised by the accumulation of surfactant within the alveoli, leading to impaired gas exchange. This case involves a 31-year-old male presenting with shortness of breath. Fine crackles were heard on auscultation, raising the suspicion of alveolar involvement. High-Resolution Computed Tomography (HRCT) of the chest revealed a “crazy paving” pattern in the bilateral lung parenchyma, a hallmark imaging finding in PAP. Histopathological analysis confirmed the diagnosis, showing alveoli filled with granular, eosinophilic, Periodic Acid Schiff (PAS)-positive material, indicative of surfactant accumulation. The patient was scheduled for Whole Lung Lavage (WLL), the standard therapeutic procedure for PAP, under General Anaesthesia (GA). A Double-lumen Endotracheal Tube (DLT) was employed to facilitate isolation of each lung, ensuring effective lavage of the affected lung while maintaining ventilation in the other. This case highlights the importance of a multidisciplinary approach, integrating clinical evaluation, advanced imaging, histopathology and specialised anaesthetic techniques in managing rare conditions like PAP. This comprehensive strategy aims to restore alveolar function and improve the patient’s respiratory status, underscoring the critical role of timely diagnosis and intervention in rare pulmonary disorders.https://jcdr.net/articles/PDF/20719/76044_CE[Ra1]_F(SS)_QC(AN_SL)_PF1(AG_IS)_PFA(IS)_PB(AG_IS)_PN(IS).pdfbronchopulmonary lavagepulmonary surfactantsingle-lung ventilation
spellingShingle Dasara Nongbet
Priyanka Dev
Vijay Noel Nongpiur
John Muchahary
Pranjal Kalita
Anaesthetic Challenges in Pulmonary Alveolar Proteinosis: A Rare Case Report
Journal of Clinical and Diagnostic Research
bronchopulmonary lavage
pulmonary surfactant
single-lung ventilation
title Anaesthetic Challenges in Pulmonary Alveolar Proteinosis: A Rare Case Report
title_full Anaesthetic Challenges in Pulmonary Alveolar Proteinosis: A Rare Case Report
title_fullStr Anaesthetic Challenges in Pulmonary Alveolar Proteinosis: A Rare Case Report
title_full_unstemmed Anaesthetic Challenges in Pulmonary Alveolar Proteinosis: A Rare Case Report
title_short Anaesthetic Challenges in Pulmonary Alveolar Proteinosis: A Rare Case Report
title_sort anaesthetic challenges in pulmonary alveolar proteinosis a rare case report
topic bronchopulmonary lavage
pulmonary surfactant
single-lung ventilation
url https://jcdr.net/articles/PDF/20719/76044_CE[Ra1]_F(SS)_QC(AN_SL)_PF1(AG_IS)_PFA(IS)_PB(AG_IS)_PN(IS).pdf
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