Bilateral Peripheral Infiltrates Refractory to Immunosuppressants were Diagnosed as Autoimmune Pulmonary Alveolar Proteinosis and Improved by Inhalation of Granulocyte/Macrophage-Colony Stimulating Factor

Hironori Satoh, Ryushi Tazawa, Tomohiro Sakakibara, Shinya Ohkouchi, Masahito Ebina, Makoto Miki, Koh Nakata, Toshihiro Nukiwa

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

A 55-year-old non-smoking woman was admitted to our hospital for re-evaluation of unimproved peripheral ground-glass opacities despite prednisolone and cyclosporine treatment. She was diagnosed with autoimmune pulmonary alveolar proteinosis (PAP) based on transbronchial lung biopsy and granulocyte/macrophage colony-stimulating factor (GM-CSF) antibody testing. GM-CSF inhalation therapy markedly improved the opacities. Bilateral, centrally located lung opacities are typical in PAP, however 10 PAP cases with peripheral infiltration were reported in Japan recently, of which GM-CSF antibody was positive in six. To avoid inappropriate immunosuppressant treatment, PAP should be considered in the differential diagnosis of such peripheral opacities. GM-CSF antibody might be useful for diagnosis.

Original languageEnglish
Pages (from-to)1737-1742
Number of pages6
JournalInternal Medicine
Volume51
Issue number13
DOIs
Publication statusPublished - 2012 Jul 10

Keywords

  • GM-CSF antibody
  • GM-CSF inhalation
  • Pulmonary alveolar proteinosis
  • Steroid therapy
  • Subpleural infiltration

ASJC Scopus subject areas

  • Internal Medicine

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