Abstract | BACKGROUND: CASE PRESENTATION: A 52-year-old woman treated at our hospital because of polymyositis with interstitial pneumonia had maintained remission by immunosuppressive treatment for 15 years. She had progressive dyspnea subsequently over several months with her chest CT showing ground-glass opacities (GGO) in bilateral geographic distribution. Her bronchoalveolar lavage fluid with cloudy appearance revealed medium-sized foamy macrophages and PAS-positive amorphous eosinophilic materials by cytological examination. We diagnosed her as APAP due to an increased serum GM-CSF autoantibody level. Attenuating immunosuppression failed to lead GGO improvement, but whole lung lavage (WLL) was effective in her condition. CONCLUSIONS: PAP should be considered as one of the differential diseases when the newly interstitial shadow was observed during immunosuppressive treatment. WLL should be regarded as the treatment option for APAP concurred in connective tissue disease (CTD).
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Authors | S Sato, K Akasaka, H Ohta, Y Tsukahara, G Kida, E Tsumiyama, K Kusano, T Oba, T Nishizawa, R Kawabe, H Yamakawa, M Amano, H Matsushima, T Takada |
Journal | BMC pulmonary medicine
(BMC Pulm Med)
Vol. 20
Issue 1
Pg. 84
(Apr 06 2020)
ISSN: 1471-2466 [Electronic] England |
PMID | 32252718
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Autoantibodies
- Immunosuppressive Agents
- Granulocyte-Macrophage Colony-Stimulating Factor
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Topics |
- Autoantibodies
(blood)
- Autoimmune Diseases
(diagnosis, immunology, physiopathology)
- Bronchoalveolar Lavage Fluid
(cytology)
- Dyspnea
(etiology)
- Female
- Granulocyte-Macrophage Colony-Stimulating Factor
(immunology)
- Humans
- Immunosuppressive Agents
(adverse effects)
- Lung
(physiopathology)
- Lung Diseases, Interstitial
(complications, drug therapy)
- Middle Aged
- Polymyositis
(complications, drug therapy)
- Pulmonary Alveolar Proteinosis
(diagnosis, immunology, physiopathology, therapy)
- Tomography, X-Ray Computed
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