Document Detail


Pulmonary alveolar proteinosis.
MedLine Citation:
PMID:  21632797     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Pulmonary alveolar proteinosis (PAP) is a rare pulmonary disease characterised by alveolar accumulation of surfactant. It may result from mutations in surfactant proteins or granulocyte macrophage-colony stimulating factor (GM-CSF) receptor genes, it may be secondary to toxic inhalation or haematological disorders, or it may be auto-immune, with anti-GM-CSF antibodies blocking activation of alveolar macrophages. Auto-immune alveolar proteinosis is the most frequent form of PAP, representing 90% of cases. Although not specific, high-resolution computed tomography shows a characteristic "crazy paving" pattern. In most cases, bronchoalveolar lavage findings establish the diagnosis. Whole lung lavage is the most effective therapy, especially for auto-immune disease. Novel therapies targeting alveolar macrophages (recombinant GM-CSF therapy) or anti-GM-CSF antibodies (rituximab and plasmapheresis) are being investigated. Our knowledge of the pathophysiology of PAP has improved in the past 20 yrs, but therapy for PAP still needs improvement.
Authors:
R Borie; C Danel; M-P Debray; C Taille; M-C Dombret; M Aubier; R Epaud; B Crestani
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European respiratory review : an official journal of the European Respiratory Society     Volume:  20     ISSN:  1600-0617     ISO Abbreviation:  Eur Respir Rev     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-06-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9111391     Medline TA:  Eur Respir Rev     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  98-107     Citation Subset:  IM    
Affiliation:
Service de Pneumologie A, Centre de Compétences des Maladies Pulmonaires Rares, ¶ Laboratoire d'Anatomie Pathologique, + Service de Radiologie, Assistance Publique Hôpitaux de Paris, Hôpital Bichat, # Inserm, Unité 700, Faculté Bichat, Université Paris 7, § Université Paris Diderot, Faculté de Médecine site Bichat, Paris, f Inserm, Unité 955, Université Paris-Est Créteil Val de Marne, and ** Centre intercommunal de Créteil, Créteil, France.
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