A combination therapy of whole lung lavage and GM‐CSF inhalation in pulmonary alveolar proteinosis

• Published in: Pediatric pulmonology Vol. 43; no. 8; pp. 828 - 830
• Main Authors: Yamamoto, Hajime, Yamaguchi, Etsuro, Agata, Hiroatsu, Kandatsu, Nobuhisa, Komatsu, Toru, Kawai, Seiko, Baba, Kenji, Awaya, Tomonari, Nishikomori, Ryuta, Tsurusawa, Masahito, Nakata, Koh
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.08.2008; Wiley-Liss
• Subjects: Administration, Inhalation; Biological and medical sciences; Bronchoalveolar Lavage; Child; child case; Combined Modality Therapy; Female; General aspects; Granulocyte-Macrophage Colony-Stimulating Factor - administration & dosage; Granulocyte-Macrophage Colony-Stimulating Factor - therapeutic use; Humans; inhalation therapy; Medical sciences; Pneumology; Pulmonary Alveolar Proteinosis - drug therapy; Pulmonary Alveolar Proteinosis - therapy; surfactant protein‐D; Treatment Outcome; Human; inhalation therapy; Lung disease; Pediatrics; Drug combination; Respiratory disease; Lung; Surfactant; Protein; Inhalation; Case study; child case; Pulmonary alveolar proteinosis; Pulmonary surfactant; surfactant protein-D; Combined treatment; Child; Granulocyte macrophage colony stimulating factor; Pneumology
• ISSN: 8755-6863; 1099-0496
• DOI: 10.1002/ppul.20856

Systemic and inhalation therapy of granulocyte‐macrophage colony‐stimulating factor (GM‐CSF) is usually effective in controlling autoimmune pulmonary alveolar proteinosis (PAP), but some cases are refractory to GM‐CSF therapy and subjected to whole lung lavage (WLL). A 9‐year‐old girl developed severe respiratory failure due to autoimmune PAP was treated with inhalational 250 µg of GM‐CSF daily, however, it was ineffective. Unilateral WLL was performed three times and subsequent GM‐CSF inhalation therapy yielded marked physiological and radiological improvement and was continued for 1 year. Pediatr Pulmonol. 2008; 43:828–830. © 2008 Wiley‐Liss, Inc.