Two Cases Of Pulmonary Alveolar Proteinosis Were Reported And Reviewed The Literature

Objective To improve the understanding of the clinical features of pulmonary alveolar proteinosis and reduce the rate of misdiagnosis and missed diagnosis,The ultimate goal is improving the rate of diagnosis of the disease clinicians and clinical curative effect.Methods Analyzing the clinical data of two cases of pulmonary alveolar proteinosis hospitalized in our department from 2014 to 2015,and reviewing the literature published from 2006 to 2015 in the domestic literature about this disease,Analyzing the disease of the age distribution,gender composition,risk factors,clinical manifestation,misdiagnosis,diagnosis and differential diagnosis and treatment.Results The disease can occur at any age,the incidence of male is more than female,PAP patients are more likely to combining with infection,mainly manifested as cough,difficulty breathing after activity,no signs or less,showing the typical imaging as "paving stone","map like" changes,the main methods for diagnosing the disease is Transbronchial lung biopsy or bronchoalveolar lavage fluid examination,easily misdiagnosed as idiopathic pulmonary fibrosis,alveolar cell carcinoma,pneumonia and other diseases,the majority of patients diagnosed can improve symptoms by bronchoalveolar lavageConclusion1.Pulmonary alveolar proteinosis is nonspecific,usually presenting with typical clinical symptoms but signs were relatively mild or no and lung imaging changes significantly,the most easily misdiagnosed is idiopathic pulmonary fibrosis.Lung imaging change obviously,and clinical manifestations are not typical,and antibiotics,hormone therapy in patients are no effect,the disease may need to consider,bronchoscopic biopsy or bronchoscopy with bronchoalveolar lavage is easily to diagnosing.?2.History of dust exposure and smoking maybe are the risks factor for the disease.3.Diagnosis rate is high with transbronchial lung biopsyor or bronchoscopy bronchoalveolar lavage fluid examination,such as the emergencing of a large number of alveolar PAS positive milk samples or mud deposition could be identified.4.Most of the patients treated by bronchoalveolar lavage,the symptoms can be alleviated,and imaging,lung function and blood gas analysis results better than before.