Rituximab Therapy in Pulmonary Alveolar Proteinosis: A Case Report

Autoimmune pulmonary alveolar proteinosis (PAP) is a rare lung condition characterized by the accumulation of surfactant proteins within the alveoli, leading to respiratory distress. We describe a 49-year-old female homemaker with a history of passive smoking and exposure to wood smoke and pigeon droppings. She presented with a dry cough and progressive dyspnea, experiencing significant deterioration in her condition over one year. Chest imaging revealed bilateral alveolar-interstitial syndrome with ground-glass opacities and alveolar condensations. Biopsy findings indicated type II pneumocytes and eosinophilic material, confirming a diagnosis of autoimmune PAP. After ruling out secondary causes of PAP, rituximab was administered successfully, leading to marked improvement in respiratory function and significant regression of radiological lesions within two months. This case highlights the importance of early diagnosis and treatment of autoimmune PAP, demonstrating the potential efficacy of rituximab in managing this challenging condition.