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Pulmonary alveolar proteinosis and cytomegalovirus infection
Abstract:
We report a case of pulmonary alveolar proteinosis (PAP) and cytomegalovirus (CMV) infection occurring in a 5-year-old boy with acute lymphoblastic leukemia. The association of PAP and CMV infection is rare, but the possible etiologic role of CMV in the production of PAP is raised. Pulmonary alveolar proteinosis is being reported with increasing frequency in immunocompromised patients, and this disease may be difficult to distinguish from other causes of diffuse lung disease both clinically and radiologically. Pulmonary alveolar proteinosis, either alone or in combination with CMV infection, should therefore be considered in the differential diagnosis of diffuse lung disease in these cases.
Insights
Pulmonary alveolar proteinosis (PAP) and cytomegalovirus (CMV) infection rarely co-occur in children with acute lymphoblastic leukemia. This case suggests CMV may play a role in causing PAP in immunocompromised patients.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Pulmonology
Background:
- Acute lymphoblastic leukemia (ALL) is a common childhood cancer.
- Immunocompromised patients are susceptible to opportunistic infections and novel pulmonary complications.
- Pulmonary alveolar proteinosis (PAP) is a rare lung disease characterized by surfactant accumulation.
Observation:
- A 5-year-old boy with ALL presented with diffuse lung disease.
- The patient was diagnosed with both pulmonary alveolar proteinosis (PAP) and cytomegalovirus (CMV) infection.
- The co-occurrence of PAP and CMV infection in this context is uncommon.
Findings:
- Cytomegalovirus (CMV) infection is implicated as a potential cause of PAP.
- PAP is increasingly observed in immunocompromised individuals.
- Distinguishing PAP from other diffuse lung diseases can be clinically and radiologically challenging.
Implications:
- PAP, with or without concurrent CMV infection, should be considered in the differential diagnosis of diffuse lung disease in immunocompromised children.
- Early recognition and diagnosis are crucial for appropriate management.
- Further research is warranted to elucidate the precise role of CMV in PAP pathogenesis.