Pulmonary alveolar proteinosis

  • Definition
    • Pulmonary alveolar proteinosis is a rare disease in which a type of protein builds up in the air sacs (alveoli) of the lungs, making breathing difficult.

  • Alternative Names
    • Alveolar proteinosis; Pulmonary alveolar phospholipoproteinosis

  • Causes
    • In some cases, the cause of pulmonary alveolar proteinosis is unknown. In others, it occurs with lung infection or an immune problem. It also can occur with cancers of the blood system, and after exposure to high levels of environmental substances, such as silica or aluminum dust.

      People between 30 and 50 years old are affected. The condition is seen in men more often than in women. A form of the disorder is present at birth (congenital).

  • Symptoms
  • Exams and Tests
  • Treatment
    • Treatment involves washing out the protein substance from the lung (whole-lung lavage) from time to time. Some persons may need a lung transplant. Avoiding dusts that might have caused the condition is also recommended.

      Another treatment that may be tried is a blood-stimulating drug called granulocyte-macrophage colony stimulating factor (GM-CSF), which is lacking in some persons with alveolar proteinosis.

  • Outlook (Prognosis)
    • Some people with this condition go into remission. Others have respiratory failure that gets worse, and they may need a lung transplant. Up to 25% of people with this condition die within 5 years of being diagnosed.

  • When to Contact a Medical Professional
    • Call your health care provider if you develop serious breathing symptoms. Shortness of breath that gets worse over time may signal that your condition is developing into a medical emergency.

  • References
    • Levine SM. Alveolar filling disorders. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 91.

      Trapnell BC, Luisetti M. Pulmonary alveolar proteinosis syndrome. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 70.