@article {Luisetti1220, author = {M. Luisetti and G. Rodi and C. Perotti and I. Campo and F. Mariani and E. Pozzi and B. C. Trapnell}, title = {Plasmapheresis for treatment of pulmonary alveolar proteinosis}, volume = {33}, number = {5}, pages = {1220--1222}, year = {2009}, doi = {10.1183/09031936.00097508}, publisher = {European Respiratory Society}, 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 μg{\textperiodcentered}mL-1 to 156 μg{\textperiodcentered}mL-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 μg{\textperiodcentered}mL-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.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/33/5/1220}, eprint = {https://erj.ersjournals.com/content/33/5/1220.full.pdf}, journal = {European Respiratory Journal} }