title: Six cases of pulmonary alveolar proteinosis: presentation of unusual associations.
abstract: We report the cases of six patients with pulmonary alveolar proteinosis (PAP). Four of the patients were adults, two males and two females (mean age 39 +/- 19 yrs). The other two patients were children, both females, one aged 6 years and one 3 days old. The diagnosis was made by thoracotomy-lung biopsy in two subjects, autopsy in two, transbronchoscopic biopsy in one and bronchoalveolar lavage (BAL) in one. Some of our cases presented unusual associations that have not been described previously in the medical literature: renal tubular acidosis, Fanconi's disease, glioblastoma multiforme and atrioventricular septal defect. In two patients, treatment with acetylcysteine and ambroxol was unsuccessful. Therapeutic BAL improved the clinical, analytical, functional and radiological aspects of two cases. In one subject, three months after the diagnosis of PAP, pulmonary tuberculosis appeared. Both diseases disappeared with antituberculous treatment.
authors.affiliation: Dept of Pulmonology, La Paz Hospital, School of Medicine, Autonoma University, Madrid, Spain.
authors.forename: F
authors.initials: F
authors.lastname: García Río
authors.forename: R
authors.initials: R
authors.lastname: Alvarez-Sala
authors.forename: P
authors.initials: P
authors.lastname: Caballero
authors.forename: C
authors.initials: C
authors.lastname: Prados
authors.forename: J M
authors.initials: JM
authors.lastname: Pino
authors.forename: J
authors.initials: J
authors.lastname: Villamor
mesh_terms: D000111:Acetylcysteine / Q000627:therapeutic use; D000328:Adult; D000551:Ambroxol / Q000627:therapeutic use; D001706:Biopsy; D001932:Brain Neoplasms / Q000150:complications; D001992:Bronchoalveolar Lavage Fluid; D002648:Child; D005198:Fanconi Syndrome / Q000150:complications; D005260:Female; D005909:Glioblastoma / Q000150:complications; D006343:Heart Septal Defects / Q000150:complications; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy; D011649:Pulmonary Alveolar Proteinosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D012129:Respiratory Function Tests; D014397:Tuberculosis, Pulmonary / Q000150:complications
chemical_list: D000551:Ambroxol; D000111:Acetylcysteine