Pulmonary Alveolar Proteinosis: A Report of Seven Patients from King Chulalongkorn Memorial Hospital
Kamon Kawkitinarong MD*, Chanchai Sittipunt MD*, Somkiat Wongtim MD*, Visit Udompanich MD*
Affiliation : * Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chulalongkorn University
From 1983 to 2001, 7 patients with pulmonary alveolar proteinosis were admitted to the King Chulalongkorn Memorial Hospital. Presenting symptoms varied from asymptomatic (1 patient), progressive dyspnea on exertion (4 patients) to respiratory failure (2 patients). Other symptoms included dry cough and weight loss. Gradual onset of dyspnea could be observed by average time to hospital (7 months). Early worsening of dyspnea and high-grade fever suggested a possibility of superimposed infection. Chest radio- graphs revealed symmetrical infiltration without lobar predominance. 4 of 7 patients were misdiagnosed as pulmonary tuberculosis before diagnosis of PAP was made. Diagnosis was made by bronchoscopic examina- tion with typical lavage fluid or pathological results; only one case need open lung biopsy. 6 of 7 patients required lung lavage to relieve dyspneic symptoms. Coinfection with Nocardia and Mycobacterium tubercu- losis was found in one patient. Prognosis was good but recurrence was common.
Keywords : Alveolar proteinosis, Clinical features, Treatment
