Pulmonary alveolar proteinosis (PAP) is a rare lung disease, and this case series describes three patients with heterogeneous clinical presentations, management strategies, and outcomes. Whole lung lavage is indicated for symptomatic patients with significant functional and gas exchange impairment. In contrast, asymptomatic patients with no functional deficit may be kept under close observation with radiologic and pulmonary function follow-up. Although outcomes of PAP treatment are usually favorable and spontaneous resolution may occur in a subset of patients, the evolution of disease and response to therapy can be unpredictable. Some patients may develop progressive disease or complications despite optimal management. This case series highlights the marked heterogeneity of PAP and underscores the need for individualized, patient-centered decision-making rather than a uniform therapeutic approach.
Singh et al. (Wed,) studied this question.