Pulmonary alveolar proteinosis (PAP) is a rare disorder characterised by accumulation of lipoproteinaceous material in the alveolar air spaces.
Diagnosis depends on histopathological and radiological features. Treatment includes whole lung lavage (WLL) and GM-CSF therapy. We present
a case report of primary idiopathic PAP treated with bilateral whole lung lavage. A 50 year old female presented with history of progressive
breathlessness and recurrent lower respiratory tract infection. There were bilateral basal ne crepitations on auscultation and she was maintaining
saturation of 70% at room air. Serial chest radiographs showed persistent bilateral alveolar opacities. HRCT thorax showed crazy paving pattern
involving both lungs. BAL uid showed lipoproteinaceous material which was PAS stain positive. Patient was subsequently treated with bilateral
WLLfollowing which there was radiological and clinical improvement
Crazy-Paving Pattern: A Rare Case of Autoimmune Pulmonary Alveolar Proteinosis (PAP) with Positive Anti-GM-CSF Antibody Following Cryptococcal Infection in an otherwise Healthy Individual and Review of Literature