Bilateral Peripheral Infiltrates Refractory to Immunosuppressants were Diagnosed as Autoimmune Pulmonary Alveolar Proteinosis and Improved by Inhalation of Granulocyte/Macrophage-Colony Stimulating Factor
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- Satoh Hironori
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan Department of Medical Biochemistry, Tohoku University Graduate School of Medicine, Japan
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- Tazawa Ryushi
- Bioscience Medical Research Center, Niigata University Medical and Dental Hospital, Japan
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- Sakakibara Tomohiro
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan
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- Ohkouchi Shinya
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan
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- Ebina Masahito
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan
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- Miki Makoto
- Department of Respiratory Medicine, Japanese Red Cross Sendai Hospital, Japan
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- Nakata Koh
- Bioscience Medical Research Center, Niigata University Medical and Dental Hospital, Japan
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- Nukiwa Toshihiro
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan South Miyagi Medical Center, Japan
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抄録
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.<br>
収録刊行物
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- Internal Medicine
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Internal Medicine 51 (13), 1737-1742, 2012
一般社団法人 日本内科学会