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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概要
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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.
著者
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Nukiwa Toshihiro
Department Of Respiratory Medicine Division Of Cancer Control Institute Of Development Aging And Can
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Nakata Koh
Bioscience Medical Research Center Niigata University
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Miki Makoto
Department Of Respiratory Medicine Division Of Cancer Control Institute Of Development Aging And Can
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Ebina Masahito
Department Of Respiratory Medicine Tohoku University Graduate School Of Medicine
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Sakakibara Tomohiro
Department Of Respiratory Medicine Tohuku University Hospital
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Ebina Masahito
Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan
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Satoh Hironori
Department of Respiratory Medicine, 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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Ohkouchi Shinya
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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Sakakibara Tomohiro
Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan
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