Difference between revisions of "Pulmonary alveolar proteinosis"

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| Prevalence = uncommon
| Prevalence = uncommon
| Bloodwork  = anti-GM-CSF antibodies, LDH elevated
| Bloodwork  = anti-GM-CSF antibodies, LDH elevated
| Rads      = airspace disease, "crazy paving"
| Rads      = airspace disease, "[[crazy paving]]"
| Endoscopy  =
| Endoscopy  =
| Prognosis  = benign
| Prognosis  = benign
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Clinical:
Clinical:
*Dyspnea & cough - gradual onset.
*[[Dyspnea]] & cough - gradual onset.
*Anti-GM-CSF antibodies - usually.<ref name=pmid16517574>{{Cite journal  | last1 = Lin | first1 = FC. | last2 = Chang | first2 = GD. | last3 = Chern | first3 = MS. | last4 = Chen | first4 = YC. | last5 = Chang | first5 = SC. | title = Clinical significance of anti-GM-CSF antibodies in idiopathic pulmonary alveolar proteinosis. | journal = Thorax | volume = 61 | issue = 6 | pages = 528-34 | month = Jun | year = 2006 | doi = 10.1136/thx.2005.054171 | PMID = 16517574 }}</ref>
*Anti-GM-CSF antibodies - usually.<ref name=pmid16517574>{{Cite journal  | last1 = Lin | first1 = FC. | last2 = Chang | first2 = GD. | last3 = Chern | first3 = MS. | last4 = Chen | first4 = YC. | last5 = Chang | first5 = SC. | title = Clinical significance of anti-GM-CSF antibodies in idiopathic pulmonary alveolar proteinosis. | journal = Thorax | volume = 61 | issue = 6 | pages = 528-34 | month = Jun | year = 2006 | doi = 10.1136/thx.2005.054171 | PMID = 16517574 }}</ref>
*Serum LDH elevated.<ref name=pmid16517574/><ref name=pmid24532945>{{Cite journal  | last1 = Bhattacharyya | first1 = D. | last2 = Barthwal | first2 = MS. | last3 = Katoch | first3 = CD. | last4 = Rohatgi | first4 = MG. | last5 = Hasnain | first5 = S. | last6 = Rai | first6 = SP. | last7 = Arora | first7 = A. | title = Primary alveolar proteinosis - A report of two cases. | journal = Med J Armed Forces India | volume = 69 | issue = 1 | pages = 90-3 | month = Jan | year = 2013 | doi = 10.1016/j.mjafi.2012.02.016 | PMID = 24532945 }}</ref>
*Serum LDH elevated.<ref name=pmid16517574/><ref name=pmid24532945>{{Cite journal  | last1 = Bhattacharyya | first1 = D. | last2 = Barthwal | first2 = MS. | last3 = Katoch | first3 = CD. | last4 = Rohatgi | first4 = MG. | last5 = Hasnain | first5 = S. | last6 = Rai | first6 = SP. | last7 = Arora | first7 = A. | title = Primary alveolar proteinosis - A report of two cases. | journal = Med J Armed Forces India | volume = 69 | issue = 1 | pages = 90-3 | month = Jan | year = 2013 | doi = 10.1016/j.mjafi.2012.02.016 | PMID = 24532945 }}</ref>
*Decreased oxygen saturation.
*Decreased oxygen saturation.
==Gross==
[[File:Crazy paving pattern on chest CT scan.jpg|thumb|Chest CT showing [[crazy paving]] pattern. (WC/Verma)]]
*Consolidation.
<gallery>
Image:Alveolar proteinosis (5397198260).jpg | PAP. (WC/Rosen)
</gallery>


===Radiology===
===Radiology===
*CXR: airspace disease.
*CXR: airspace disease.
*HRCT: "crazy paving" - see: [http://radiographics.rsnajnls.org/cgi/content/figsonly/23/6/1509 http://radiographics.rsnajnls.org/cgi/content/figsonly/23/6/1509].
*HRCT: "[[crazy paving]]".


==Microscopic==
==Microscopic==
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===Images===
===Images===
www:
*[http://jcp.bmjjournals.com/content/62/5/387/F23.large.jpg PAP (bmjjournals.com)].<ref name=pmid19398592>{{cite journal |author=Leslie KO |title=My approach to interstitial lung disease using clinical, radiological and histopathological patterns |journal=J. Clin. Pathol. |volume=62 |issue=5 |pages=387–401 |year=2009 |month=May |pmid=19398592 |pmc=2668105 |doi=10.1136/jcp.2008.059782 |url=}}</ref>
<gallery>
<gallery>
Image:Pulmonary_alveolar_proteinosis_-3-_low_mag.jpg | PAP - low mag. (WC)
Image:Pulmonary_alveolar_proteinosis_-3-_low_mag.jpg | PAP - low mag. (WC)
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Image:Pulmonary_alveolar_proteinosis_-_very_high_mag.jpg | PAP - very high mag. (WC)
Image:Pulmonary_alveolar_proteinosis_-_very_high_mag.jpg | PAP - very high mag. (WC)
</gallery>
</gallery>
Images of DDx:
<gallery>
Image:Alveolar proteinosis (5396599841).jpg | PAP (WC/Rosen)
Image:Alveolar proteinosis (5397198452).jpg | PAP (WC/Rosen)
</gallery>
www:
*[http://jcp.bmjjournals.com/content/62/5/387/F23.large.jpg PAP (bmjjournals.com)].<ref name=pmid19398592>{{cite journal |author=Leslie KO |title=My approach to interstitial lung disease using clinical, radiological and histopathological patterns |journal=J. Clin. Pathol. |volume=62 |issue=5 |pages=387–401 |year=2009 |month=May |pmid=19398592 |pmc=2668105 |doi=10.1136/jcp.2008.059782 |url=}}</ref>
 
Images of DDx (pulmonary edema):
*[http://www.sciencephoto.com/media/98443/enlarge Pulmonary edema (sciencephoto.com)].
*[http://www.sciencephoto.com/media/98443/enlarge Pulmonary edema (sciencephoto.com)].


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