Management of pulmonary alveolar proteinosis by repeated bronchoalveolar lavage

Pulmonary alveolar proteinosis is a rare disease of the lung in which excessive thick granular phospholipoproteinaceous material accumulates within the air spaces. Many patients with this disease suffer from progressive dyspnea and cough that at times is accompanied by worsening hypoxia. At present, the only effective treatment is bronchoalveolar lavage, first described by Ramirez in 1963 (1). Presumably, this therapy is effective because it washes the proteinaceous debris from the airways and alveolar spaces. This case report describes the management of pulmonary alveolar proteinosis in 1 patient, who has undergone multiple, alternating, single-lung lavages over the past 10 years, with dramatic improvements in her symptoms following each therapy. We believe this to be the longest reported treatment of pulmonary alveolar proteinosis with repetitive bronchoalveolar lavage.