title: Pulmonary alveolar proteinosis in a patient with acute lymphoid leukemia regression after G-CSF therapy.
abstract: Pulmonary alveolar proteinosis (PAP) is the intra-alveolar accumulation of periodic-acid schiff (PAS) positive material. PAP is one of the underrecognized causes of pulmonary infiltrates in patients with hematologic malignancies. Here, we present a patient with acute lymphoid leukemia (ALL) in first remission that developed fever and diffuse pulmonary infiltrates during the neutropenic stage of consolidation chemotherapy. The histopathologic examination of bronchoalveolar lavage (BAL) fluid and transbronchial biopsy specimen demonstrated the presence of PAS-positive eosinophilic material. Empirical antibiotherapy and granulocyte-colony stimulating factor (G-CSF) were given. After the correction of neutropenia with G-CSF, the patient's fever disappeared, acute phase reactants decreased, pulmonary infiltrates resolved. We present this case because it was the first patient in whom the correction of neutropenia with G-CSF was followed by resolution of PAP.
authors.affiliation: Department of Hematology, Trakya Medical Faculty, University of Trakya, Edirne, Turkey. gepamuk@yahoo.com
authors.forename: Gülsüm Emel
authors.initials: GE
authors.lastname: Pamuk
authors.forename: Burhan
authors.initials: B
authors.lastname: Turgut
authors.forename: Ozden
authors.initials: O
authors.lastname: Vural
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Demir
authors.forename: Osman
authors.initials: O
authors.lastname: Hatipoğlu
authors.forename: Ercüment
authors.initials: E
authors.lastname: Unlü
authors.forename: Semsi
authors.initials: S
authors.lastname: Altaner
authors.forename: Murat
authors.initials: M
authors.lastname: Gerenli
authors.forename: Bilge
authors.initials: B
authors.lastname: Cakir
mesh_terms: D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D017254:Leukemic Infiltration; D008875:Middle Aged; D009503:Neutropenia / Q000188:drug therapy; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy; D011649:Pulmonary Alveolar Proteinosis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D012074:Remission Induction
chemical_list: D016179:Granulocyte Colony-Stimulating Factor