Pulmonary alveolar proteinosis case

Chief Complaint A 69 y/o male presents with the complaint of worsening cough and SOB. History He has a 20 years history of smoking. He smokes 10-12 cigarettes per day. He has h/o DM. Investigations Chest x ray showed right middle lobe infiltrate. We treated him with levofloxacin. Which was not effected. So we advised CT, which shows b/l ground glass opacities Transbronchial biopsy shows proteinaceous material in the alveolar space. Diagnosis He was diagnosed with Pulmonary alveolar proteinosis. Treatment Please discuss the treatment plan.


Whole lung lavage is ideal along with treating underlying cause. In case of autoimmune PAP, GM CSF would be helpful. In cases of refractory PAP,Rituximab, plasmapheresis, and lung transplant are long term treatment options.

Whole Lung Lavage is ideal treatment plasmapheresis or lung transplant helpful

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