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ArticleRadiology case reports2025

Hereditary pulmonary alveolar proteinosis in a 5-year-old child: Diagnostic insights and therapeutic approach.

Dhiran Sivasubramanian, Karthick Balasubramanian, Sathwik Sanil, Smrti Aravind, Virushnee Senthilkumar

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In one paragraph

Article in Radiology case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Dhiran SivasubramanianDepartment of Cardiology, Children's hospital of Philadelphia, PA, USA.
Karthick BalasubramanianDepartment of Critical Care Medicine, Christian Medical College, Vellore, India.
Sathwik SanilInstitute of Oncology, Sri Ramakrishna Hospital, Coimbatore, India.
Smrti AravindDepartment of General Medicine, Coimbatore Medical College, Coimbatore, India.
Virushnee SenthilkumarDepartment of General Medicine, Coimbatore Medical College, Coimbatore, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Hereditary pulmonary alveolar proteinosis (hPAP) is a rare disorder caused by mutations in the CSF2RA or CSF2RB genes, leading to impaired surfactant clearance by alveolar macrophages and subsequent respiratory dysfunction. A 5-year-old female with a 2-year history of poor weight gain, fatigue, and intermittent fever was evaluated. Clinical evaluation revealed hypoxemia, while high-resolution computed tomography (HRCT) of the chest showed the characteristic "crazy-paving" pattern suggestive of PAP. Bronchoalveolar lavage (BAL) yielded milky fluid with periodic acid-Schiff (PAS)-positive material, and genetic testing confirmed a homozygous mutation in the CSF2RA gene, consistent with hPAP. The patient underwent therapeutic whole lung lavage (WLL), resulting in significant clinical improvement. This case underscores the challenges of diagnosing pediatric hPAP and the value of integrating imaging, pathology, and genetic testing. While WLL remains the mainstay of treatment, further research is needed to develop targeted therapies.

Indexed as

Bronchoalveolar lavage (BAL)Crazy-paving patternCSF2RA mutationHereditary pulmonary alveolar proteinosis (hPAP)Pediatric respiratory diseaseWhole lung lavage (WLL)

Identifiers

PMID40486150
PMCPMC12145514

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