Autoimmune pulmonary alveolar proteinosis with features similar to nonspecific interstitial pneumonia

Koki Fujii; Hideyuki Takeshima; Taku Nishimura; Toshio Sakatani; Yoshio Masuda; Teppei Morikawa; Kazuhiro Usui

doi:10.1016/j.rmcr.2022.101591

Autoimmune pulmonary alveolar proteinosis with features similar to nonspecific interstitial pneumonia

Respir Med Case Rep. 2022 Feb 3:36:101591. doi: 10.1016/j.rmcr.2022.101591. eCollection 2022.

Authors

Koki Fujii¹, Hideyuki Takeshima¹, Taku Nishimura¹, Toshio Sakatani¹, Yoshio Masuda², Teppei Morikawa², Kazuhiro Usui¹

Affiliations

¹ Division of Respirology, NTT Medical Center Tokyo, Tokyo, Japan.
² Department of Diagnostic Pathology, NTT Medical Center Tokyo, Tokyo, Japan.

Abstract

A 58-year-old woman with cough and dyspnea who was suspected of having idiopathic interstitial pneumonia had been treated with corticosteroids and cyclosporine, but the symptoms had worsened. There were no findings to suspect pulmonary alveolar proteinosis (PAP) in the bronchoalveolar lavage fluid, 17 months after the start of treatment. The transbronchial lung biopsy specimens showed eosinophilic bodies that strongly stained with periodic acid-Schiff staining. Anti-granulocyte macrophage colony-stimulating factor (anti-GM-CSF) antibodies were detected in her serum. We diagnosed the patient with autoimmune PAP. Thus, we present a rare case of PAP presenting atypical radiological images and bronchoalveolar lavage fluid findings.

Keywords: Anti-GM-CSF antibody; Autoimmune pulmonary alveolar proteinosis; Bronchoalveolar lavage fluid; Ground-glass opacities; Nonspecific interstitial pneumonia.

Publication types

Case Reports