Abhilash Narvenkar, Uday C. Kakodkar, Chetan Kerkar, John Muchahary


Pulmonary alveolar proteinosis (PAP) is a rare disorder characterised by accumulation of lipoproteinaceous material in the alveolar air spaces.
Diagnosis depends on histopathological and radiological features. Treatment includes whole lung lavage (WLL) and GM-CSF therapy. We present
a case report of primary idiopathic PAP treated with bilateral whole lung lavage. A 50 year old female presented with history of progressive
breathlessness and recurrent lower respiratory tract infection. There were bilateral basal ne crepitations on auscultation and she was maintaining
saturation of 70% at room air. Serial chest radiographs showed persistent bilateral alveolar opacities. HRCT thorax showed crazy paving pattern
involving both lungs. BAL uid showed lipoproteinaceous material which was PAS stain positive. Patient was subsequently treated with bilateral
WLL following which there was radiological and clinical improvement.

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