A case of idiopathic pulmonary alveolar proteinosis accompanied by T-cell receptor gene rearrangement in bronchoalveolar lavage fluid cells.
We describe a case of a patient with idiopathic pulmonary alveolar proteinosis (PAP), who had an elevated serum level of antigranulocyte-macrophage colony stimulating factor (anti-GM-CSF) antibody accompanied by T-cell receptor gene rearrangements in BAL fluid cells. Histopathological examination of the lung excluded lymphoma but revealed PAP and silicosis. There was no detectable serum anti-GM-CSF antibody in 50 outpatients with advanced silicosis who did not have PAP, suggesting that anti-GM-CSF antibody is directly linked to PAP but not to silicosis. We speculate that monoclonal expansion of a T-cell population may play a role in the production of anti-GM-CSF antibody and the development of PAP.
Hosokawa
Takeshi
T
First Department of Medicine, Hokkaido University School of Medicine, Sapporo, Hokkaido, Japan. takeshihosokawa@yahoo.co.jp
Yamaguchi
Etsuro
E
Shirai
Shinya
S
Fuke
Satoshi
S
Takaoka
Kazuo
K
Kojima
Jun-Ichiro
J
Nakata
Koh
K
Nishimura
Masaharu
M
D000368:Aged; D015139:Blotting, Southern; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology*; D015329:Gene Rearrangement, T-Lymphocyte; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000276:immunology*; D006801:Humans; D008297:Male; D011649:Pulmonary Alveolar Proteinosis / Q000235:genetics*
D016178:Granulocyte-Macrophage Colony-Stimulating Factor