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

doi:10.2169/internalmedicine.51.6093

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 journal › Article › peer-review

7 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 language	English
Pages (from-to)	1737-1742
Number of pages	6
Journal	Internal Medicine
Volume	51
Issue number	13
DOIs	https://doi.org/10.2169/internalmedicine.51.6093
Publication status	Published - 2012
Externally published	Yes

Keywords

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

ASJC Scopus subject areas

Internal Medicine

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Satoh, H., Tazawa, R., Sakakibara, T., Ohkouchi, S., Ebina, M., Miki, M., Nakata, K., & Nukiwa, T. (2012). Bilateral Peripheral Infiltrates Refractory to Immunosuppressants were Diagnosed as Autoimmune Pulmonary Alveolar Proteinosis and Improved by Inhalation of Granulocyte/Macrophage-Colony Stimulating Factor. Internal Medicine, 51(13), 1737-1742. https://doi.org/10.2169/internalmedicine.51.6093

Bilateral Peripheral Infiltrates Refractory to Immunosuppressants were Diagnosed as Autoimmune Pulmonary Alveolar Proteinosis and Improved by Inhalation of Granulocyte/Macrophage-Colony Stimulating Factor. / Satoh, Hironori; Tazawa, Ryushi; Sakakibara, Tomohiro et al.

In: Internal Medicine, Vol. 51, No. 13, 2012, p. 1737-1742.

Research output: Contribution to journal › Article › peer-review

Satoh, H, Tazawa, R, Sakakibara, T, Ohkouchi, S, Ebina, M, Miki, M, Nakata, K & Nukiwa, T 2012, 'Bilateral Peripheral Infiltrates Refractory to Immunosuppressants were Diagnosed as Autoimmune Pulmonary Alveolar Proteinosis and Improved by Inhalation of Granulocyte/Macrophage-Colony Stimulating Factor', Internal Medicine, vol. 51, no. 13, pp. 1737-1742. https://doi.org/10.2169/internalmedicine.51.6093

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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.",

keywords = "GM-CSF antibody, GM-CSF inhalation, Pulmonary alveolar proteinosis, Steroid therapy, Subpleural infiltration",

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

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AU - Sakakibara, Tomohiro

AU - Ohkouchi, Shinya

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AU - Nakata, Koh

AU - Nukiwa, Toshihiro

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AB - 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.

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KW - Steroid therapy

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

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

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