A biochemical study on bronchopulmonary lavage fluid from a case of pulmonary alveolar proteinosis

A 44-year-old male was hospitalized, because of the presence of abnormal shadows on chest x-ray film. Diagnosis of pulmonary alveolar proteinosis was established by examination of a specimen obtained by transbronchial biopsy. Therapeutic bronchopulmonary lavage was performed twice. As a result, there was an improvement of radiological findings on chest x-ray film. Then a biochemical study was carried out with pooled lavage fluids. Cellular debris were removed by centrifugation. Lipids were extracted with a 2:1 mixture of chloroform and methanol. Individual phospholipids were identified by column chromatography and thin layer chromatography. Fatty acids were identified by gas chromatography. It was found that phosphatidyl choline (lecithine) was the major component of phospholipids. On the other hand, myristic acid of the molecule of phosphatidyl choline was found to constitute 19.6% of the total fatty acids. This patient lives a normal life as of Dec. 1980.