PULMONARY ALVEOLAR PROTEINOSIS - CASE-REP ORT WITH SEQUENTIAL-ANALYSIS OF BRONCHOALVEOLAR LAVAGE CELL DATA FOLLOWING THERAPEUTIC WHOLE LUNGLAVAGE

Pulmonary alveolar proteinosis (PAP) is a rare disease characterized b y the accumulation of lipoproteinaceous material within the alveoli. T hough many studies addressed biochemical datas in bronchoalveolar lava ge (BAL) effluent, poor attention was payed to cell profile in PAP. We report the case of a 40 years old woman, presenting with progressive respiratory failure and bilateral pulmonary infiltrates. BAL and trans bronchial biopsy confirmed PAP. Therapeutic whole lung lavage led to f ull clinical and radiological remission. Sequential BAL follow-up was started over a 4-years period. As previously reported, lymphocytes wer e increased prior to whole lung lavage. This pattern subsequently rema ined, whereas recurrence or superinfections did not occur. The mechani sm of this disorder is nuclear and deserves further investigation.