title: Pulmonary alveolar proteinosis in China: a systematic review of 241 cases.
abstract: OBJECTIVE
  Pulmonary alveolar proteinosis (PAP) is a rare pulmonary disease. It was first described in China in 1965, and more cases have been reported subsequently. A systematic review was performed on 241 cases of PAP in China and progress in the diagnosis and treatment of this disease is discussed.
  
  
  METHODS
  The Chinese biological and medical databases from 1965 to 2006 were searched and 241 cases with complete clinical and pathological data were identified. The clinical characteristics of the disease were summarized and longitudinal comparisons were made of diagnostic and treatment methods over time.
  
  
  RESULTS
  The morbidity associated with PAP has increased in recent years. The clinical manifestations were non-specific. Progressive dyspnoea, cough and sputum were the most common symptoms. The percentage of patients undergoing CT examination has increased over the years. The combination of bronchoscopic biopsy and bronchoalveolar lavage (BAL) was usually sufficient to establish the diagnosis. Treatment was reported for a total of 142 cases. BAL and whole lung lavage were both effective and were only required once by most patients.
  
  
  CONCLUSIONS
  The demographic characteristics and clinical manifestations of PAP patients in China are largely consistent with previous reports. Morbidity has increased dramatically in recent years, mainly due to the broad application of bronchoscopy since 1995. CT is very important for diagnosis of the disease. The long-term effects of treatment by whole lung lavage and BAL are similar.
authors.affiliation: Department of Respiratory Medicine, Second Affiliated Hospital of Zhejiang, Zhejiang, China.
authors.forename: Zhihao
authors.initials: Z
authors.lastname: Xu
authors.forename: Jiyong
authors.initials: J
authors.lastname: Jing
authors.forename: Huiying
authors.initials: H
authors.lastname: Wang
authors.forename: Feng
authors.initials: F
authors.lastname: Xu
authors.forename: Jiaoli
authors.initials: J
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018893:Bronchoalveolar Lavage; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011649:Pulmonary Alveolar Proteinosis / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology*; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed; D055815:Young Adult