Improvement of native pulmonary alveolar proteinosis after contralateral single living-donor lobar lung transplantation: A case report

Kazuma Kobayashi, Shinya Ohkouchi, Yoji Sasahara, Masahito Ebina, Koh Nakata, Ryoko Saito, Miki Akiba, Tetsu Sado, Hisashi Oishi, Tatsuaki Watanabe, Hajime Kurosawa, Yoshinori Okada

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

PAP is a rare disease characterized by the accumulation of surfactant materials in the alveolar spaces due to the imbalance of surfactant homeostasis (production and clearance). We herein report a case of an 8-year-old girl who developed PAP after BMT from her mother for the treatment of DBA. The anemia was improved by BMT; however, respiratory dysfunction due to graft-versus-host disease gradually progressed. She eventually underwent right single LDLLT from her mother when she was 14 years old. A pathological examination of the excised lung confirmed the finding of diffuse bronchiolitis obliterans and unexpectedly revealed widespread alveolar proteinosis. Interestingly, the GGO of her native left lung on chest X-ray was improved after LDLLT. We present the very unique clinical course of this patient and discuss the mechanisms underlying the development of PAP after BMT and its improvement after LDLLT from the same donor.

Original languageEnglish
Article numbere13659
JournalPediatric Transplantation
Volume24
Issue number2
DOIs
Publication statusPublished - 2020 Mar 1

Keywords

  • bone marrow transplantation
  • diamond-Blackfan-Anemia
  • lung transplantation
  • macrophages
  • one antigen mismatch
  • secondary pulmonary alveolar proteinosis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

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