Pulmonary Alveolar Proteinosis in a Foundry Worker: Report of One Case

Pulmonary alveolar proteinosis (PAP) is a rare disease, and few cases are associated with foundry work. We describe a case of a 48-year-old male foundry worker who presented with a chronic cough and whitish sputum for more than two months and a sudden onset of chest pain with progressive dyspnea. Initial impression upon admission was pneumonia. Treatment with empiric antibiotics was started immediately, but the condition deteriorated after two days of treatment and a chest radiograph showed diffuse infiltrations in bilateral lungs. The patient underwent open lung biopsy for a definite diagnosis, and pathological findings revealed PAP. Bilateral whole-lung lavage was performed on two different occasions and resulted in significant improvement of the patient's condition. In conclusion, PAP remains a rare disease with progressive dyspnea as the most significant symptom, and should be suspected if occupational inhalation of respirable silica is possible. Open lung biopsy can provide a definite diagnosis, and whole-lung lavage is the treatment of choice for PAP.

並列關鍵字

pulmonary alveolar proteinosis ； occupational disease ； foundry worker ； silica

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