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Pulmonary Alveolar Proteinosis: Response to Nebulized Enzyme Therapy

Pulmonary Alveolar Proteinosis: Response to Nebulized Enzyme Therapy Abstract Since the original report by Rosen, Castleman, and Liebow1 in June, 1958, of the then-new entity of pulmonary alveolar proteinosis, many additional cases have been reported.2-19 The name is now well established and a fairly characteristic clinical pattern is beginning to emerge. Despite the wide geographical distribution of this disease and the increasing number of cases, the etiology remains unknown, and the treatment, where it has been attempted, has been entirely empirical. None of the cases reported has shown dramatic response to any of the treatments employed. A case of pulmonary alveolar proteinosis, previously proven by lung biopsy has been treated with streptokinase-streptodornase enzyme aerosol, with a marked concomitant change in findings. Since this case has been previously reported,19 only the details relevant to the treatment are included in this report. Report of Case A 32-year-old white man, screw-machine operator, was found to have pulmonary alveolar proteinosis References 1. Composed of Triton WR-1339, 0.125%; sodium bicarbonate, 2%; glycerine, 5% solution. 2. Rosen, S. H.; Castleman, B., and Liebow, A. A.: Pulmonary Alveolar Proteinosis , New Engl. J. Med. 258:1123-1142, 1958.Crossref 3. Carlson, D. J., and Mason, E. W.: Pulmonary Alveolar Proteinosis: Diagnosis of Probable Case by Examination of Sputum , Amer. J. Clin. Path. 33:48-54, 1960. 4. Sieracki, J. C.; Horn, R. C., Jr., and Kay, S.: Pulmonary Alveolar Proteinosis: Report of 3 Cases , Ann. Intern. Med. 51:728-739, 1959.Crossref 5. Moertel, C. G.; Wollner, L. B., and Bernatz, P. E.: Pulmonary Alveolar Proteinosis: Report of a Case , Proc. Mayo Clin. 134:152-157, 1959. 6. Payseur, C. R.; Konwaler, B. E., and Hyde, L.: Pulmonary Alveolar Proteinosis: A Progessive, Diffuse, Fatal Pulmonary Disease , Amer. Rev. Tuberc. 78:906-915, 1958. 7. Pulmonary Alveolar Proteinosis: Case Report, in Quarterly Progress Report of the Veterans Administration-Armed Forces Study on the Chemotherapy of Tuberculosis 13:25, 1958. 8. Landis, F. B.; Rose, H. D., and Sternlieb, R. O.: Pulmonary Alveolar Proteinosis: A Case Report with Unusual Clinical and Laboratory Manifestations , Amer. Rev. Resp. Dis. 80:249-254, 1959. 9. Harrison, E. G., Jr., et al.: Pulmonary Alveolar Proteinosis: Report of Case with Fatal Outcome , J.A.M.A. 173:327-332, 1960.Crossref 10. Lull, G. F., Jr., et al.: Pulmonary Alveolar Proteinosis: Report of Two Cases , Amer. J. Roentgenol. 82:76-83, 1959. 11. Edmondson, W. R., and Gere, I. B.: Pulmonary Alveolar Proteinosis (Case Report) , Amer. J. Intern. Med. 52:1310-1318, 1960.Crossref 12. Fraimow, W.; Cathcart, R. T., and Taylor, R. C.: Physiologic and Clinical Aspects of Pulmonary Alveolar Proteinosis , Ann. Intern. Med. 52:1177-1194, 1960.Crossref 13. Fraimow, W., et al.: Pulmonary Alveolar Proteinosis: A Correlation of Pathological and Physiological Findings in a Patient Followed Up with Serial Biopsies of the Lung , Amer. J. Med. 28:458-467, 1960.Crossref 14. Furst, W. E.; Bell, B. M, and Irons, G. V., Jr.: Asymptomatic Pulmonary Alveolar Proteinosis , Amer. J. Med. 28:453-457, 1960.Crossref 15. Jones, C. C.: Pulmonary Alveolar Proteinosis with Unusual Complicating Infections , Amer. J. Med. 29:713-721, 1960.Crossref 16. Plenk, H. P., et al.: Pulmonary Alveolar Glycoproteinosis (Pneumocystic Pneumonitis) , Radiology 74:928-938, 1960.Crossref 17. Andersen, B. R.; Ecklund, R. E., and Killow, W. F.: Pulmonary Alveolar Proteinosis with Systemic Nocardosis , J.A.M.A. 174:28-31, 1960.Crossref 18. Stern, H., et al.: Pulmonary Alveolar Proteinosis: A Case Report , Dis. Chest 34:82-86, 1961.Crossref 19. Burbank, B., et al.: Pulmonary Alveolar Proteinosis and Nocardosis , Amer. J. Med. 28: 1002-1007, 1960.Crossref 20. Slutzker, B., et al.: Pulmonary Alveolar Proteinosis: Case Report and Review of Literature , A.M.A. Arch. Intern. Med. 107:264-269, 1961.Crossref 21. Dickstein, B.: Enzyme Lysis of Asthmatic Sputum , Ann. Allergy 17:784-801, 1959. 22. Goodman, D. H.: Personal communications. 23. Brodsky, I., and Mayock, R. L.: Pulmonary Alveolar Proteinosis: Remission After Treatment with Trypsin and Chymotrypsin , New Engl. J. Med. 265:935-938, 1961.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Pulmonary Alveolar Proteinosis: Response to Nebulized Enzyme Therapy

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References (20)

Publisher
American Medical Association
Copyright
Copyright © 1962 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1962.03620160032005
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Abstract

Abstract Since the original report by Rosen, Castleman, and Liebow1 in June, 1958, of the then-new entity of pulmonary alveolar proteinosis, many additional cases have been reported.2-19 The name is now well established and a fairly characteristic clinical pattern is beginning to emerge. Despite the wide geographical distribution of this disease and the increasing number of cases, the etiology remains unknown, and the treatment, where it has been attempted, has been entirely empirical. None of the cases reported has shown dramatic response to any of the treatments employed. A case of pulmonary alveolar proteinosis, previously proven by lung biopsy has been treated with streptokinase-streptodornase enzyme aerosol, with a marked concomitant change in findings. Since this case has been previously reported,19 only the details relevant to the treatment are included in this report. Report of Case A 32-year-old white man, screw-machine operator, was found to have pulmonary alveolar proteinosis References 1. Composed of Triton WR-1339, 0.125%; sodium bicarbonate, 2%; glycerine, 5% solution. 2. Rosen, S. H.; Castleman, B., and Liebow, A. A.: Pulmonary Alveolar Proteinosis , New Engl. J. Med. 258:1123-1142, 1958.Crossref 3. Carlson, D. J., and Mason, E. W.: Pulmonary Alveolar Proteinosis: Diagnosis of Probable Case by Examination of Sputum , Amer. J. Clin. Path. 33:48-54, 1960. 4. Sieracki, J. C.; Horn, R. C., Jr., and Kay, S.: Pulmonary Alveolar Proteinosis: Report of 3 Cases , Ann. Intern. Med. 51:728-739, 1959.Crossref 5. Moertel, C. G.; Wollner, L. B., and Bernatz, P. E.: Pulmonary Alveolar Proteinosis: Report of a Case , Proc. Mayo Clin. 134:152-157, 1959. 6. Payseur, C. R.; Konwaler, B. E., and Hyde, L.: Pulmonary Alveolar Proteinosis: A Progessive, Diffuse, Fatal Pulmonary Disease , Amer. Rev. Tuberc. 78:906-915, 1958. 7. Pulmonary Alveolar Proteinosis: Case Report, in Quarterly Progress Report of the Veterans Administration-Armed Forces Study on the Chemotherapy of Tuberculosis 13:25, 1958. 8. Landis, F. B.; Rose, H. D., and Sternlieb, R. O.: Pulmonary Alveolar Proteinosis: A Case Report with Unusual Clinical and Laboratory Manifestations , Amer. Rev. Resp. Dis. 80:249-254, 1959. 9. Harrison, E. G., Jr., et al.: Pulmonary Alveolar Proteinosis: Report of Case with Fatal Outcome , J.A.M.A. 173:327-332, 1960.Crossref 10. Lull, G. F., Jr., et al.: Pulmonary Alveolar Proteinosis: Report of Two Cases , Amer. J. Roentgenol. 82:76-83, 1959. 11. Edmondson, W. R., and Gere, I. B.: Pulmonary Alveolar Proteinosis (Case Report) , Amer. J. Intern. Med. 52:1310-1318, 1960.Crossref 12. Fraimow, W.; Cathcart, R. T., and Taylor, R. C.: Physiologic and Clinical Aspects of Pulmonary Alveolar Proteinosis , Ann. Intern. Med. 52:1177-1194, 1960.Crossref 13. Fraimow, W., et al.: Pulmonary Alveolar Proteinosis: A Correlation of Pathological and Physiological Findings in a Patient Followed Up with Serial Biopsies of the Lung , Amer. J. Med. 28:458-467, 1960.Crossref 14. Furst, W. E.; Bell, B. M, and Irons, G. V., Jr.: Asymptomatic Pulmonary Alveolar Proteinosis , Amer. J. Med. 28:453-457, 1960.Crossref 15. Jones, C. C.: Pulmonary Alveolar Proteinosis with Unusual Complicating Infections , Amer. J. Med. 29:713-721, 1960.Crossref 16. Plenk, H. P., et al.: Pulmonary Alveolar Glycoproteinosis (Pneumocystic Pneumonitis) , Radiology 74:928-938, 1960.Crossref 17. Andersen, B. R.; Ecklund, R. E., and Killow, W. F.: Pulmonary Alveolar Proteinosis with Systemic Nocardosis , J.A.M.A. 174:28-31, 1960.Crossref 18. Stern, H., et al.: Pulmonary Alveolar Proteinosis: A Case Report , Dis. Chest 34:82-86, 1961.Crossref 19. Burbank, B., et al.: Pulmonary Alveolar Proteinosis and Nocardosis , Amer. J. Med. 28: 1002-1007, 1960.Crossref 20. Slutzker, B., et al.: Pulmonary Alveolar Proteinosis: Case Report and Review of Literature , A.M.A. Arch. Intern. Med. 107:264-269, 1961.Crossref 21. Dickstein, B.: Enzyme Lysis of Asthmatic Sputum , Ann. Allergy 17:784-801, 1959. 22. Goodman, D. H.: Personal communications. 23. Brodsky, I., and Mayock, R. L.: Pulmonary Alveolar Proteinosis: Remission After Treatment with Trypsin and Chymotrypsin , New Engl. J. Med. 265:935-938, 1961.Crossref

Journal

Archives of Internal Medicine – American Medical Association

Published: Apr 1, 1962

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