Autoimmune Pulmonary Alveolar Proteinosis Complicated with Sarcoidosis: the Clinical Course and Serum Levels of Anti-granulocyte-macrophage colony-stimulating Factor Autoantibody

  • Arai Toru
    Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Japan
  • Kasai Takahiko
    Department of Pathology, National Hospital Organization Kinki-Chuo Chest Medical Center, Japan
  • Shimizu Kazunori
    Department of Pulmonary Critical Care Medicine, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Japan
  • Kawahara Kunimitsu
    Department of Pathology, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Japan
  • Katayama Kanako
    Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Japan
  • Sugimoto Chikatoshi
    Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Japan
  • Hirose Masaki
    Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Japan
  • Okamoto Hiroyuki
    Department of Dermatology, Kansai Medical University, Japan
  • Tachibana Kazunobu
    Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Japan Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Japan
  • Akira Masanori
    Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Japan Department of Radiology, National Hospital Organization Kinki-Chuo Chest Medical Center, Japan
  • Inoue Yoshikazu
    Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Japan

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Abstract

<p>Autoimmune pulmonary alveolar proteinosis (APAP) is caused by macrophage dysfunction due to anti-granulocyte-macrophage colony-stimulating factor (GM-CSF) autoantibody. We experienced 2 cases of APAP complicated with sarcoidosis in a 42-year-old woman and a 51-year-old man (age at the sarcoidosis diagnosis). APAP preceded sarcoidosis in the woman, and both diseases were diagnosed simultaneously in the man. Sarcoidosis lesions were observed in the lung, skin, and eyes, and the pathological findings of APAP were not marked at the diagnosis of sarcoidosis in either case. Low-grade positive serum anti-GM-CSF autoantibody was suspected to be correlated with the occurrence of sarcoidosis and resolution of APAP. </p>

Journal

  • Internal Medicine

    Internal Medicine 59 (20), 2539-2546, 2020-10-15

    The Japanese Society of Internal Medicine

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