Pulmonary alveolar proteinosis in a patient with acute lymphoid leukemia regression after G-CSF therapy.
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.
Pamuk
Gülsüm Emel
GE
Department of Hematology, Trakya Medical Faculty, University of Trakya, Edirne, Turkey. gepamuk@yahoo.com
Turgut
Burhan
B
Vural
Ozden
O
Demir
Muzaffer
M
Hatipoğlu
Osman
O
Unlü
Ercüment
E
Altaner
Semsi
S
Gerenli
Murat
M
Cakir
Bilge
B
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
D016179:Granulocyte Colony-Stimulating Factor