Clinical Features and Outcomes of Idiopathic Pulmonary Alveolar Proteinosis in Korean Population.
10.3346/jkms.2010.25.3.393
- Author:
Min Kwang BYUN
1
;
Dong Soon KIM
;
Young Whan KIM
;
Man Pyo CHUNG
;
Jae Jeong SHIM
;
Seung Ick CHA
;
Soo Taek UH
;
Choon Sik PARK
;
Sung Hwan JEONG
;
Yong Bum PARK
;
Hong Lyeol LEE
;
Moo Suk PARK
Author Information
1. Division of Pulmonary Medicine, Department of Internal Medicine, Yonsei University, College of Medicine, Yonsei University Health System, Seoul, Korea. pms70@yuhs.ac
- Publication Type:Original Article
- Keywords:
Pulmonary Alveolar Proteinosis;
Irrigation;
Treatment Outcome;
Koreans
- MeSH:
Adult;
Biopsy;
Bronchoalveolar Lavage;
Female;
Humans;
Korea;
Male;
Middle Aged;
Pulmonary Alveolar Proteinosis/diagnosis/pathology/*physiopathology/*therapy;
Respiratory Function Tests;
Retrospective Studies;
Survival Rate;
Treatment Outcome
- From:Journal of Korean Medical Science
2010;25(3):393-398
- CountryRepublic of Korea
- Language:English
-
Abstract:
Idiopathic pulmonary alveolar proteinosis (PAP) is a rare disorder in which lipoproteinaceous material accumulates within alveoli. There were few reports on Asian populations with idiopathic PAP. We retrospectively reviewed 38 patients with idiopathic PAP in Korea. We assessed clinical features, therapeutic efficacy and outcomes of whole lung lavage in patients with idiopathic PAP. The mean age at diagnosis was 52 yr. Eighty six percent of patients were symptomatic at diagnosis. Dyspnea and cough were the most common symptoms. Crackles were the most common physical examination finding. On pulmonary function test, a mild restrictive ventilatory defect was common, with a predicted mean forced vital capacity (FVC) of 77% and forced expiratory volume in one second (FEV1) of 84.6%. Diffusing capacity was disproportionately reduced at 67.7%. Arterial blood gas analysis revealed hypoxemia with a decreased PaO2 of 69.0 mmHg and an increased D(A-a)O2 of 34.2 mmHg. After whole lung lavage, PaO2, D(A-a)O2 and DLCO were significantly improved, but FVC and total lung capacity (TLC) were not different. This is the first multicenter study to analyze 38 Korean patients with idiopathic PAP. The clinical features and pulmonary parameters of Korean patients with idiopathic PAP are consistent with reports in other published studies. Whole lung lavage appears to be the most effective form of treatment.