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Pulmonary Alveolar Proteinosis and Whole Lung Lavage in a Tertiary Center From Romania: A Study on Twenty Patients FREE TO VIEW

Oana Deleanu; Ana Nebunoiu; Carolina Tarasova; Aneta Serbescu; Radu Stoica; Genoveva Cadar; Oana Arghir; Florin Mihaltan, MD
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"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania

Chest. 2014;146(4_MeetingAbstracts):375A. doi:10.1378/chest.1993338
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SESSION TITLE: Interstitial Lung Disease Posters II

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: We aimed to describe clinical features of a rare condition which determines an interstitial-like syndrome - pulmonar alveolar proteinosis (PAP), specific imagistic, pathologic findings and to describe our center’s experience in whole lung lavage (WLL), main PAP treatment accepted at this moment.

METHODS: We effectuated a retrospective analysis of all files from all admissions of patients with PAP from the period January 2007- December 2012 in a tertiar pneumology center in Romania; data where noted and analyzed.

RESULTS: A number of 20 patients (13 males, sex ratio 1.86:1) where identified with PAP during the noted period. Mean age at first evaluation was 41.9±16.5 years, 4 patients had exposure to respiratory noxes, 4 were smokers, 4 former smokers (all women were non-smokers). Diagnostic was made in all patients using broncho-alveolar lavage. Descriptive analysis of the group was made concerning clinical, paraclinical and evolution aspects. From 20 patients, 14 effectuated whole lung lavage (WLL) at least one time during the 6 years period (minimum 1, maximum 6, mean 2.64±1.4 WLL/patient), 2 patients had a contraindication of WLL and 4 patients did not meet the criteria for WLL. A total of 36 WLL were performed (period between two consecutive WLL was 4,9±4,1 months). Complications due to WLL were severe postprocedural hypoxemia in 2 cases and pneumotorax in one case. When analysing the differences between those having indication of WLL (including those in whom WLL wasn’t performed due to contraindication), the only significant difference that we found was that patients with indication of WLL had lower values in procentual forced vital capacity (FVC%), p=0.01 and procentual forced expiratory volume in 1 second (FEV1%), p=0.008. One spontan remission and one death due to respiratory insuficiency were noted.

CONCLUSIONS: This is, to our knowledge, an analysis of the biggest cohort of PAP patients in Romania.

CLINICAL IMPLICATIONS: Study revealed that in the absence of precise indications for WLL, the clinical presentation of the patient and the severity of restriction as objective paraclinical method are the main findings that dictate the need of WLL.

DISCLOSURE: The following authors have nothing to disclose: Oana Deleanu, Ana Nebunoiu, Carolina Tarasova, Aneta Serbescu, Radu Stoica, Genoveva Cadar, Oana Arghir, Florin Mihaltan

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