Whole-lung lavage in alveolar proteinosis by a modified lavage technique.

Whole-lung lavage is the only efficient treatment in pulmonary alveolar proteinosis. A 36-year-old woman with severe pulmonary alveolar proteinosis confirmed by video-assisted thoracoscopic lung biopsies underwent repetitive whole-lung lavages without improvement. A modified technique consisting of manual ventilation between instillation and aspiration of half the amount of saline used for conventional lavage was applied. Impressive clinical and functional improvement occurred and persisted for 1 year. We believe that the amelioration can be attributed to the technique described above.