title: A case of idiopathic pulmonary alveolar proteinosis accompanied by T-cell receptor gene rearrangement in bronchoalveolar lavage fluid cells.
abstract: 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.
authors.affiliation: First Department of Medicine, Hokkaido University School of Medicine, Sapporo, Hokkaido, Japan. takeshihosokawa@yahoo.co.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hosokawa
authors.forename: Etsuro
authors.initials: E
authors.lastname: Yamaguchi
authors.forename: Shinya
authors.initials: S
authors.lastname: Shirai
authors.forename: Satoshi
authors.initials: S
authors.lastname: Fuke
authors.forename: Kazuo
authors.initials: K
authors.lastname: Takaoka
authors.forename: Jun-Ichiro
authors.initials: J
authors.lastname: Kojima
authors.forename: Koh
authors.initials: K
authors.lastname: Nakata
authors.forename: Masaharu
authors.initials: M
authors.lastname: Nishimura
mesh_terms: 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*
chemical_list: D016178:Granulocyte-Macrophage Colony-Stimulating Factor