Plasmapheresis for treatment of pulmonaryalveolar proteinosis

M. Luisetti, G. Rodi, C. Perotti, I. Campo, F. Mariani, E. Pozzi, B. C. Trapnell

Research output: Contribution to journalArticle

Abstract

Whole lung lavage (WLL) is currently the standard therapy for pulmonary alveolar proteinosis (PAP). Nevertheless, some PAP patients respond poorly to WLL or require it frequently. The present paper reports a patient with autoimmune PAP with persistent disease despite three WLL treatments over 10 months. Plasmapheresis with ten 1.5-L plasma exchanges was performed, which lowered the serum granulocyte-macrophage colony-stimulating factor (GM-CSF) autoantibody level from 250 μgmL-1 to 156 mgmL-1 but did not improve respiratory impairment. Further WLL therapy was required and transiently effective. Serum GM-CSF autoantibody levels declined progressively, reaching a value of 56 mgmL-1 80 weeks after completion of plasmapheresis. However, this decrease was not accompanied by clinical improvement and the patient required additional WLL therapy. The results confirm that minor reductions in serum granulocyte-macrophage colony-stimulating factor autoantibody levels from plasmapheresis are not reflected in clinical improvement in the severity of lung disease in pulmonary alveolar proteinosis.

Original languageEnglish
Pages (from-to)1220-1222
Number of pages3
JournalEuropean Respiratory Journal
Volume33
Issue number5
DOIs
Publication statusPublished - May 2009

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Keywords

  • Autoantibodies
  • Granulocyte-macrophage colony-stimulating factor
  • Surfactant
  • Whole lung lavage

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Medicine(all)

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