Background: Pulmonary alveolar proteinosis (PAP) is a rare lung disorder characterized by the accumulation of surfactant within the alveoli, leading to impaired gas exchange and respiratory insufficiency. Although the disease is uncommon, it significantly affects patients’ quality of life and requires specific diagnostic and therapeutic approaches. Whole lung lavage (WLL) is considered the standard treatment; however, it has not been widely implemented in Mongolia. We report the first successful case of WLL performed for PAP in Mongolia. Case Presentation: A 56-year-old male presented with dyspnea. Chest computed tomography demonstrated a bilateral “crazy paving” pattern. Bronchoalveolar lavage fluid was positive for periodic acid–Schiff (PAS) staining, and anti–GM-CSF antibodies were detected, confirming the diagnosis of PAP. WLL was performed under general anesthesia using a double-lumen endotracheal tube with bronchoscopic guidance. One lung was ventilated with 100% oxygen while the contralateral lung was sequentially lavaged with 800–1000 mL of warm (37°C) saline per cycle until the effluent became clear. A total of approximately 20 liters of saline was used. Result: The procedure was completed successfully without complications. Following treatment, the patient showed marked clinical improvement with reduced dyspnea and increased exercise tolerance. Oxygen saturation improved from 88% to 93%, and spirometric parameters (FVC, FEV₁) demonstrated improvement. Chest imaging revealed a reduction in pulmonary opacities. Conclusion This case demonstrates the successful implementation of whole lung lavage (WLL) in Mongolia and highlights its importance in improving the diagnostic and therapeutic capacity for rare pulmonary diseases such as pulmonary alveolar proteinosis. The procedure resulted in significant improvement in clinical, functional, and radiological parameters, consistent with findings from international studies. Early diagnosis of PAP and the adoption of standardized protocols in accordance with international guidelines are essential to optimize treatment outcomes and enhance patients’ quality of life.

Introduction: According to World Health Organization, air pollution is a major environmental risk to health and is estimated to cause approximately 1.6 million premature deaths worldwide per year. The air pollution of Ulaanbaatar city is rising year after year.Goal: The aim of this study was to define the lung function of adults in Ulaanbaatar.Materials and Methods: 1196 adults were randomly chosen aged over 20 years of Ulaanbaatar city. Of them 238 subjects were excluded because they had at least one of the following: a history of lung diseases including asthma, COPD, pulmonary tuberculosis, lung fibrosis; symptoms of chronic cough, wheeze, or dyspnea; history of thoracic surgery; history of major acute illness in the past 3 months; or a history of respiratory tract infection in the past 4 weeks. Besides demographic data, information on smoking habits was collected. The lung ventilation function of subjects was checked using a spirometry EasyOne, calculating the indexes Forced expiratory volume 1sec (FEV1), forced vital capacity (FVC), FEV1/FVC ratio. Lung function measurements followed a standardized protocol and fulfilled the ATS criteria.Results: Of the respondents, 486 were males (50.7%) and 472 were females (49.3%). There was a negative correlation between each lung function and age (p<0.05). The lung function was significantly lower in female than in male, for FEV1, FVC (male - FEV1 3.66±0.659 L, FVC 4.467±0.716 L, female-FEV1 2.663+0.559 L, FVC 3.237+0.586 L). In overall, FVC, FEV1 was decreased by 34.5, 37.2 percent, respectively compared with European LLN value.Conclusion: The mean value for FEV1, FVC, FEV1/FVC ratio was 3.17±0.78 L, 3.86+0.89 L and 82.02±6.75 % in overall, respectively.