[Alveolar proteinosis after professional exposure to cotton and linen dust, successfully treated with whole lung lavage--a case report]

Abstract

Alveolar proteinosis can be primary or secondary. The secondary alveolar proteinosis was observed in infections, in malignancies and after exposition to various dusts. We present a 55 year old woman with severe pulmonary alveolar proteinosis, who was exposed to cotton and linen dust in work for 20 years. The main features were slowly increasing dyspnoea and cough. Chest X-ray revealed diffuse bilateral acinar infiltrates. We observed decreased diffusing capacity, and severe hypoxaemia. The diagnosis was confirmed by transbronchial lung biopsy. Histopathology examination revealed characteristic alveolar filling by PAS-positive material. The patient underwent the whole lung lavage (WLL) with very good therapeutic effect. WLL was performed under general anaesthesia with a double-lumen endotracheal tube. We used 20 L 0.9% saline to lavage one lung. Clinical and functional improvement has persisted for over 1 year.