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Pulmonary alveolar proteinosis — SCE Respiratory MCQ

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HardILDPulmonary alveolar proteinosisSCE Respiratory

A 41-year-old man has progressive breathlessness and milky bronchoalveolar lavage fluid. HRCT shows bilateral crazy-paving with ground-glass opacity and septal thickening. Anti-GM-CSF antibody is positive and there is no immunodeficiency. What is the most appropriate management?

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Correct answer: EWhole-lung lavage in a specialist centre

Autoimmune pulmonary alveolar proteinosis with symptomatic gas-transfer impairment is treated with whole-lung lavage in specialist centres. TB treatment and pleural aspiration address different diseases. Inhaled corticosteroids and lung volume reduction do not remove alveolar surfactant accumulation.

Reference: ERS Pulmonary Alveolar Proteinosis guidance