National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Congenital pulmonary alveolar proteinosis


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Other Names:
Pulmonary alveolar proteinosis, congenital; Congenital PAP
Categories:

Congenital pulmonary alveolar proteinosis is a rare form of respiratory failure that is present from birth.[1] In this condition, a substance made up of fat and protein (surfactant) builds up in the air sacs (alveoli) of the lungs, making breathing difficult.[1] Symptoms typically begin the newborn period and get worse over time. 

Congenital pulmonary alveolar proteinosis is caused by genetic changes (mutations) in one of several different genes.  It is inherited in either an autosomal dominant, autosomal recessive or X-linked recessive pattern depending on the gene involved.  If the gene involved is the ABCA3 gene, the CSF2RB gene, or the SFTPB gene, inheritance is autosomal recessive. If the gene involved is the SFTPC gene, inheritance is autosomal dominant. If the gene involved is the CSF2RA gene, inheritance is X-linked recessive.[2] 

Congenital pulmonary alveolar proteinosis is diagnosed based on the symptoms, imaging studies and genetic testing. Treatment is difficult and can involve washing out the lungs (bronchoalveolar lavage) or lung transplant. Infants may be put on an artificial breathing machine.  Without treatment, this condition may be fatal within a few months of life.  Congenital pulmonary alveolar proteinosis is rare and occurs in about 1 in 1.5 million births.[1][2]
Last updated: 3/18/2019

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

Showing of 28 |
Medical Terms Other Names
Learn More:
HPO ID
30%-79% of people have these symptoms
Crazy paving pattern on pulmonary HRCT 0025391
Failure to thrive in infancy
Faltering weight in infancy
Weight faltering in infancy
[ more ]
0001531
Hypoxemia
Low blood oxygen level
0012418
Respiratory distress
Breathing difficulties
Difficulty breathing
[ more ]
0002098
Respiratory failure requiring assisted ventilation 0004887
Restrictive ventilatory defect
Stiff lung or chest wall causing decreased lung volume
0002091
5%-29% of people have these symptoms
Acute infectious pneumonia 0011949
Autoimmune antibody positivity 0030057
Cough
Coughing
0012735
Crackles 0030830
Elevated carcinoembryonic antigen level 0031029
Foam cells 0003651
Tachycardia
Fast heart rate
Heart racing
Racing heart
[ more ]
0001649
Tachypnea
Increased respiratory rate or depth of breathing
0002789
Percent of people who have these symptoms is not available through HPO
Abnormality of metabolism/homeostasis
Laboratory abnormality
Metabolism abnormality
[ more ]
0001939
Alveolar proteinosis 0006517
Apnea 0002104
Autosomal recessive inheritance 0000007
Clubbing
Clubbing of fingers and toes
0001217
Cyanosis
Blue discoloration of the skin
0000961
Desquamative interstitial pneumonitis 0005942
Dyspnea
Trouble breathing
0002094
Failure to thrive
Faltering weight
Weight faltering
[ more ]
0001508
Infantile onset
Onset in first year of life
Onset in infancy
[ more ]
0003593
Interstitial pulmonary abnormality
Abnormality in area between air sacs in lung
0006530
Pulmonary arterial hypertension
Increased blood pressure in blood vessels of lungs
0002092
Rapidly progressive
Worsening quickly
0003678
Respiratory failure 0002878
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Last updated: 7/1/2020

If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

Healthcare Resources


Related diseases are conditions that have similar signs and symptoms. A health care provider may consider these conditions in the table below when making a diagnosis. Please note that the table may not include all the possible conditions related to this disease.

Conditions with similar signs and symptoms from Orphanet
Differential diagnosis includes Autoimmune PAP, PAP related to the production of surfactant (e.g. due to mutations in SP-B or SP-C, ABCA3, and NKX2-1), PAP secondary to hematologic disorders and malignancies, toxic dust inhalations, and immune deficiency syndromes, rare infections, mutations affecting functions or numbers of mononuclear phagocytes, and mutations affecting lung development.
Visit the Orphanet disease page for more information.

Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources


Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease


These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

  • MedlinePlus was designed by the National Library of Medicine to help you research your health questions, and it provides more information about this topic.
  • The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them.

In-Depth Information

  • Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
  • Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine. 
  • Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Congenital pulmonary alveolar proteinosis. Click on the link to view a sample search on this topic.

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know.


  1. Blaivas AJ. Pulmonary alveolar proteinosis. MedlinePlus. Updated 5/21/2017; http://www.nlm.nih.gov/medlineplus/ency/article/000114.htm.
  2. Alavuk Kundovic S, Popovic L. Congenital pulmonary alveolar proteinosis: From birth to ten-years of age. Ind Jl of Ped. Sept 2017; 84(9):721-723. https://www.ncbi.nlm.nih.gov/pubmed/28512724.