Pulmonary Alveolar Proteinosis Secondary to Chronic Ethylene Oxide Occupational Inhalation

Abstract

In this case report, a 40-year-old male patient with a persistent and productive cough lasting over 2 weeks, accompanied by dyspnea, who received an anti-tuberculosis drug regimen for 12 months without any clinical improvement at a different hospital before being referred to Persahabatan Central General Hospital was presented. In-depth clinical, and radiological investigations, the periodic acid-Schiff (PAS)-positive related to pulmonary alveolar proteinosis (PAP) confirmed through transbronchial biopsy (TBB). PAP is a rare lung disease with exceptionally low prevalence and incidence, Notably, the patient’s occupational environment played a crucial role in the diagnosis, as we identified occupational PAP secondary to chronic inhalation of ethylene oxide in a poorly ventilated work setting and inadequate respiratory protection. The patient was administered inhaled filgrastim (1 vial) at four intervals over 30 days, yielding favorable and satisfactory clinical as well as radiological outcomes.

Keywords

• Chronic Ethylene Oxide
• Pulmonary Alveolar Proteinosis
• Pulmonary Lavage
• Transbronchial Biopsy

Mesleki olarak Kronik Etilen Oksit İnhalasyonuna Sekonder Pulmoner Alveolar Proteinozis

Abstract

Bu olgu sunumunda, 2 haftadan uzun süredir devam eden inatçı ve prodüktif öksürüğün yanı sıra nefes darlığı şikayeti olan, Persahabatan Merkez Genel Hastanesi'ne sevk edilmeden önce farklı bir hastanede 12 ay boyunca anti-tüberküloz ilaç tedavisi alan ve herhangi bir klinik iyileşme göstermeyen 40 yaşında bir erkek hasta sunulmaktadır. Ayrıntılı klinik ve radyolojik incelemelerde, pulmoner alveoler proteinozis (PAP) ile ilişkili periyodik asit-Schiff (PAS) pozitifliği, transbronşiyal biyopsi (TBB) ile doğrulandı. PAP son derece düşük prevalansı ve insidansı olan nadir bir akciğer hastalığıdır. Yetersiz havalandırılan bir çalışma ortamında ve yetersiz solunum korumasıyla kronik etilen oksit inhalasyonuna ikincil olarak mesleki PAP belirlediğimiz hastada, özellikle hastanın mesleki ortamı tanıda çok önemli bir rol oynadı. Hastaya 30 gün boyunca dört aralıkla inhale filgrastim (1 şişe) uygulandı ve olumlu ve tatmin edici klinik ve radyolojik sonuçlar elde edildi.

Keywords

• Kronik Etilen Oksit
• Pulmoner Alveoler Proteinözis
• Pulmoner Lavaj
• Transbronşiyal Biyopsi

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