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Pulmonary Alveolar Proteinosis with Ulcerative Colitis
Noriho Sakamoto1, Shota Nakashima1, Hiroshi Ishimoto1
1Department of Respiratory Medicine, Unit of Basic Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan.
A rare case of autoimmune pulmonary alveolar proteinosis (PAP) was diagnosed in a patient with ulcerative colitis. Elevated anti-granulocyte macrophage-colony stimulating factor (GM-CSF) antibodies suggest a potential link between these conditions.
Area of Science:
- Pulmonology
- Immunology
- Gastroenterology
Background:
- Pulmonary alveolar proteinosis (PAP) is a rare lung disease characterized by surfactant accumulation.
- Autoimmune PAP is associated with autoantibodies against granulocyte-macrophage colony-stimulating factor (GM-CSF).
- Inflammatory bowel disease (IBD), such as ulcerative colitis, can have complex systemic manifestations.
Observation:
- A 65-year-old man with ulcerative colitis presented with cough and dyspnea.
- Chest CT revealed a characteristic crazy-paving pattern.
- Bronchoalveolar lavage fluid was milky, and lung biopsy showed PAS-positive bodies.
Findings:
- Serum analysis revealed elevated anti-GM-CSF antibody titers.
- The patient was diagnosed with autoimmune pulmonary alveolar proteinosis (PAP).
- This case highlights a rare association between autoimmune PAP and ulcerative colitis.
Implications:
- The findings suggest a potential shared pathogenesis between autoimmune PAP and inflammatory bowel disease, possibly mediated by anti-GM-CSF antibodies.
- This association may warrant screening for PAP in IBD patients with respiratory symptoms.
- Further research is needed to elucidate the underlying mechanisms connecting these conditions.
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