Pulmonary Alveolar Proteinosis: The first South African insight into this rare disease

dc.contributor.advisorSymons, Gregory
dc.contributor.authorVorajee, Nadia
dc.date.accessioned2022-03-22T09:56:03Z
dc.date.available2022-03-22T09:56:03Z
dc.date.issued2021
dc.date.updated2022-03-22T07:40:59Z
dc.description.abstractBackground: Pulmonary alveolar proteinosis (PAP) is a rare disorder characterized by excessive accumulation of intra-alveolar surfactant related, lipoproteinaceous material. With the exception of a single pediatric case report of PAP, no data exists in Sub Saharan Africa. The aim of the study is to describe the epidemiological and clinical features of patients with PAP treated at Groote Schuur Hospital since May 2009 and their outcome after the first therapeutic whole lung lavage. Methods: 11 patients with PAP were identified using the Pulmonology whole lung lavage register. A retrospective folder review was undertaken for demographic and clinical data which was captured via a paper data capture sheet and then entered into a REDCap database for ease of statistical analysis. Findings: The median age at diagnosis was 42 years, with a male to female ratio of 1:1.2 . All the patient's tested negative for HIV. A history of smoking was seen in 63.6% (7) with median pack years of 21.5. Common symptoms at presentation included: dyspnoea (100%), dry cough (45.5%), productive cough (45.5%) and weight loss (54.5%). All patients were hypoxic at diagnosis with an average Pa02 on room air of 7.75 kPa (±1.59) and, a mean FEV1/FVC ratio of 87.60% (±7.02) of predicted. Although 36.4 % (4) were unable to perform 6 min walk tests at presentation, the remaining patients had a median distance of 287 m. No mortality was seen at 12 months, despite all patients requiring whole lung lavage during this period. Conclusions: This small, retrospective cohort offers the first insight into the demographic and clinical features of patients in Sub-Saharan Africa with PAP. Interestingly, no patients in this cohort were HIV positive. Within this small cohort very few statistically significant details can be drawn but rather a description of a rare condition. Future plans to continue data collection prospectively and expand to other centres will improve deductions made.
dc.identifier.apacitationVorajee, N. (2021). <i>Pulmonary Alveolar Proteinosis: The first South African insight into this rare disease</i>. (). ,Faculty of Health Sciences ,Department of Medicine. Retrieved from http://hdl.handle.net/11427/36193en_ZA
dc.identifier.chicagocitationVorajee, Nadia. <i>"Pulmonary Alveolar Proteinosis: The first South African insight into this rare disease."</i> ., ,Faculty of Health Sciences ,Department of Medicine, 2021. http://hdl.handle.net/11427/36193en_ZA
dc.identifier.citationVorajee, N. 2021. Pulmonary Alveolar Proteinosis: The first South African insight into this rare disease. . ,Faculty of Health Sciences ,Department of Medicine. http://hdl.handle.net/11427/36193en_ZA
dc.identifier.ris TY - Master Thesis AU - Vorajee, Nadia AB - Background: Pulmonary alveolar proteinosis (PAP) is a rare disorder characterized by excessive accumulation of intra-alveolar surfactant related, lipoproteinaceous material. With the exception of a single pediatric case report of PAP, no data exists in Sub Saharan Africa. The aim of the study is to describe the epidemiological and clinical features of patients with PAP treated at Groote Schuur Hospital since May 2009 and their outcome after the first therapeutic whole lung lavage. Methods: 11 patients with PAP were identified using the Pulmonology whole lung lavage register. A retrospective folder review was undertaken for demographic and clinical data which was captured via a paper data capture sheet and then entered into a REDCap database for ease of statistical analysis. Findings: The median age at diagnosis was 42 years, with a male to female ratio of 1:1.2 . All the patient's tested negative for HIV. A history of smoking was seen in 63.6% (7) with median pack years of 21.5. Common symptoms at presentation included: dyspnoea (100%), dry cough (45.5%), productive cough (45.5%) and weight loss (54.5%). All patients were hypoxic at diagnosis with an average Pa02 on room air of 7.75 kPa (±1.59) and, a mean FEV1/FVC ratio of 87.60% (±7.02) of predicted. Although 36.4 % (4) were unable to perform 6 min walk tests at presentation, the remaining patients had a median distance of 287 m. No mortality was seen at 12 months, despite all patients requiring whole lung lavage during this period. Conclusions: This small, retrospective cohort offers the first insight into the demographic and clinical features of patients in Sub-Saharan Africa with PAP. Interestingly, no patients in this cohort were HIV positive. Within this small cohort very few statistically significant details can be drawn but rather a description of a rare condition. Future plans to continue data collection prospectively and expand to other centres will improve deductions made. DA - 2021_ DB - OpenUCT DP - University of Cape Town KW - Medicine LK - https://open.uct.ac.za PY - 2021 T1 - Pulmonary Alveolar Proteinosis: The first South African insight into this rare disease TI - Pulmonary Alveolar Proteinosis: The first South African insight into this rare disease UR - http://hdl.handle.net/11427/36193 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/36193
dc.identifier.vancouvercitationVorajee N. Pulmonary Alveolar Proteinosis: The first South African insight into this rare disease. []. ,Faculty of Health Sciences ,Department of Medicine, 2021 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/36193en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.subjectMedicine
dc.titlePulmonary Alveolar Proteinosis: The first South African insight into this rare disease
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMMed
Files
Original bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
thesis_hsf_2021_vorajee nadia.pdf
Size:
1.22 MB
Format:
Adobe Portable Document Format
Description:
License bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
license.txt
Size:
0 B
Format:
Item-specific license agreed upon to submission
Description:
Collections