title: Autoimmune Pulmonary Alveolar Proteinosis Following Pulmonary Aspergillosis.
abstract: A 59-year-old man, ex-smoker, was diagnosed with pulmonary aspergillosis according to chest radiography findings of a fungus ball and Aspergillus fumigatus detection in the bronchial lavage fluid. Two years after anti-fungal therapy, he was diagnosed with autoimmune pulmonary alveolar proteinosis (APAP) according to a crazy paving pattern in computed tomography scans of the chest, milky bronchoalveolar lavage effluent, and positive anti-granulocyte-macrophage colony-stimulating factor (GM-CSF) autoantibody in the serum. The patient ultimately died of respiratory failure caused by APAP four months after GM-CSF therapy commenced. Aspergillus infection may thus be associated with the onset and progression of APAP and tolerance to GM-CSF therapy.
authors.affiliation: Department of Clinical Research Center, National Hospital Organization, Kinki-Chuo Chest Medical Center, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Arai
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Inoue
authors.forename: Masanori
authors.initials: M
authors.lastname: Akira
authors.forename: Koh
authors.initials: K
authors.lastname: Nakata
authors.forename: Masanori
authors.initials: M
authors.lastname: Kitaichi
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D001232:Aspergillus fumigatus / Q000302:isolation & purification; D001323:Autoantibodies / Q000276:immunology; D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000209:etiology*; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000276:immunology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011649:Pulmonary Alveolar Proteinosis / Q000188:drug therapy* / Q000209:etiology*; D055732:Pulmonary Aspergillosis / Q000150:complications* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed
chemical_list: D000935:Antifungal Agents; D001323:Autoantibodies; D016178:Granulocyte-Macrophage Colony-Stimulating Factor