Pulmonary Alveolar Proteinosis Clinical Presentation

Updated: Dec 18, 2019
  • Author: Roger B Olade, MD, MPH; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
  • Print

History and Physical Examination


Patients with pulmonary alveolar proteinosis (PAP) typically present with a gradual onset of symptoms. As many as 30% of patients are asymptomatic, even with diffuse chest radiograph abnormalities. Symptoms include the following:

  • Persistent dry cough (or scant sputum production)

  • Progressive dyspnea

  • Fatigue and malaise

  • Weight loss

  • Intermittent low-grade fever and/or night sweats

  • Pleuritic chest pain

  • Cyanosis (rare)

  • Hemoptysis (rare)

Physical examination

Physical findings are usually nonspecific. Symptoms include the following:

  • Fine end-inspiratory crackles

  • Clubbing (25%)

  • Cyanosis (20%)

  • Pulmonary hypertension and cor pulmonale (rare)