ACUTE RESPIRATORY-FAILURE CAUSED BY SECONDARY ALVEOLAR PROTEINOSIS INA PATIENT WITH ACUTE MYELOID-LEUKEMIA - A CASE-REPORT

Pulmonary alveolar proteinosis (PAP) is a rare cause of chronic respir atory failure due to progressive alveolar accumulation of a periodic a cid-schiff (PAS) positive proteinaceous material. In some cases, the r apid accumulation of in tra-alveolar material leads to acute respirato ry failure (ARF). We report the causative role of secondary PAP in the case of a 26-year-old man with acute myeloid leukemia who developed f ever, increased serum lactate deshydrogenase level and ARF, and requir ed mechanical ventilation. The diagnosis of PAP was established by the examination of material obtained by bronchoalveolar lavage (BAL). Res piratory improvement occurred several days after the patient had recov ered from neutropenia. This report underlines the importance of the ea rly diagnosis of PAP as a potential cause of ARF in leukemic patients. Adequate stain on BAL fluid provides the diagnosis and avoids repeate d invasive procedures and inappropriate treatments.