Pulmonary Alveolar Proteinosis

Abstract

Endobrachial infusions were performed with a 0.9% saline solution containing 50-75 units of heparin/ ml and 1% or 5% acetylcysteine. The chest roentgenograms cleared to a varying degree, and respiratory function improved in all cases. A return to normal of the serum levels of lactic acid dehydrogenase was noted in the 2 cases whose serum levels were initially elevated. After injecting radioactive iodinated serum albumin intravenously, its pulmonary clearance rate was measured in the 4 cases. The data supports the concept that an insufficiency of the pulmonary clearing process is of pathogenetic significance in alveolar proteinosis and that this insufficiency can be reversed at least temporarily by repeated bronchoalveolar irrigations.