Pulmonary Alveolar Proteinosis with Bilateral Ground-glass Opacities Localized in Subpleural Areas

• Mohri Keiji

  Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School

• Miyashita Naoyuki

  Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School

• Obase Yasushi

  Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School

• Fukuda Minoru

  Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School

• Ohue Yoshihiro

  Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School

• Ueno Shiro

  Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School

• Yagi Shin-ichi

  Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School

• Yoshida Koichiro

  Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School

• Kobashi Yoshihiro

  Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School

• Soda Hiroshi

  Second Department of Internal Medicine, Nagasaki University Hospital

• Oka Mikio

  Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School

Abstract

Background. Pulmonary alveolar proteinosis (PAP) located only in subpleural areas is quite rare. Case. A 32-year-old asymptomatic nonsmoker woman was found to have bilateral ground-glass opacities in subpleural areas from basal to apical segments. The bronchoalveolar lavage fluid had a light-milky appearance and contained large eosinophilic bodies stained with periodic acid-Schiff. Anti-GM-CSF antibody in the serum and the lavage fluid was markedly elevated to 632μg/ml and 1.4μg/ml, respectively. These findings were consistent with acquired PAP. The opacities partly improved spontaneously during 15 months. Conclusion. Ground-glass opacities localized in subpleural areas are rare in alveolar proteinosis, however, detailed analysis of lavage fluid should be actively done for diagnosis.

Journal

• The Journal of the Japan Society for Respiratory Endoscopy

  The Journal of the Japan Society for Respiratory Endoscopy 29 (5), 275-278, 2007

  The Japan Society for Respiratory Endoscopy

Keywords

• Chest computed tomography
• Bronchoalveolar lavage
• GM-CSF
• Anti-GM-CSF antibody
• Spontaneous improvement

Details

• CRID: 1390282679728156032
• NII Article ID: 110006478149
• NII Book ID: AN00357687
• DOI: 10.18907/jjsre.29.5_275
• ISSN: 21860149
• ISSN: 02872137
• Web Site: https://search.jamas.or.jp/link/ui/2008154888
• Text Lang: en
• Data Source:
  • JaLC
  • CiNii Articles
• Abstract License Flag: Disallowed