Unilateral Autoimmune Pulmonary Alveolar Proteinosis with Polymyositis-related Interstitial Lung Disease

Intern Med. 2022 Oct 15;61(20):3095-3100. doi: 10.2169/internalmedicine.9015-21. Epub 2022 Apr 2.

Abstract

A 61-year-old patient with cystic bronchiectasis and bronchial artery hyperplasia in the left lung was diagnosed with polymyositis-related interstitial lung disease. After nine months of immunosuppressive therapy, he developed unilateral autoimmune pulmonary alveolar proteinosis (APAP) in the right lung with respiratory failure. After bronchial artery embolization to prevent massive hemoptysis, whole-lung lavage was performed using veno-venous extracorporeal membrane oxygenation. His respiratory condition improved, and he was discharged from the hospital with supplemental oxygen. Three reported cases of APAP with polymyositis-related interstitial lung disease, including the present case, were all positive for anti-glycyl tRNA synthetase antibody and were under immunosuppressive treatment.

Keywords: anti-glycyl tRNA synthetase antibody; bronchiectasis; interstitial lung disease; polymyositis; pulmonary alveolar proteinosis; whole-lung lavage.

Publication types

  • Case Reports

MeSH terms

  • Amino Acyl-tRNA Synthetases*
  • Autoimmune Diseases
  • Bronchoalveolar Lavage
  • Humans
  • Lung Diseases, Interstitial* / complications
  • Male
  • Middle Aged
  • Oxygen
  • Polymyositis* / complications
  • Polymyositis* / diagnosis
  • Pulmonary Alveolar Proteinosis* / complications
  • Pulmonary Alveolar Proteinosis* / diagnosis

Substances

  • Amino Acyl-tRNA Synthetases
  • Oxygen

Supplementary concepts

  • Pulmonary Alveolar Proteinosis, Acquired