McDonnell MJ, Reynolds C, Tormey V, Gilmartin JJ, Rutherford RM. Pulmonary alveolar proteinosis: report of two cases in the West of Ireland with review of current literature.
Ir J Med Sci 2013;
183:123-7. [PMID:
23749726 DOI:
10.1007/s11845-013-0976-0]
[Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 05/30/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND
Pulmonary alveolar proteinosis (PAP) is a rare lung condition characterised by the accumulation of lipoproteinaceous surfactant material within alveolar airspaces resulting in clinical manifestations ranging from asymptomatic to severe respiratory failure. Three disease subtypes are recognised: autoimmune, secondary and congenital.
METHODS
We describe two presentations of PAP in the West of Ireland with a review of the current literature.
RESULTS
Autoimmune PAP, associated with the presence of granulocyte-macrophage colony-stimulating factor (GM-CSF) autoantibodies, accounts for >90 % of cases. Treatment with whole lung lavage is the current standard of care. Novel therapies targeting alveolar macrophages (recombinant GM-CSF therapy) and anti-GM-CSF antibodies (rituximab, plasmapharesis) are under investigation.
CONCLUSIONS
This is a summary of available literature outlining current clinical practice in the diagnosis, management, and treatment of PAP. PAP should be considered in the differential diagnosis of any patient with a restrictive pulmonary defect. Without high clinical suspicion, this diagnosis can easily be missed.
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