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Case Reports
. 2021 Oct 18;9(11):e0864.
doi: 10.1002/rcr2.864. eCollection 2021 Nov.

Autoimmune pulmonary alveolar proteinosis with a history of vaping and vitamin E-positive bronchoalveolar lavage

Tzy Harn Chua  1 , Angela Takano  1   2 , Yi Ju Yao  3 , Sau Yee Chow  4 , Anantham Devanand  2   5 , Chee Kiang Tay  2   5
Affiliations
Case Reports

Autoimmune pulmonary alveolar proteinosis with a history of vaping and vitamin E-positive bronchoalveolar lavage

Tzy Harn Chua et al. Respirol Case Rep. .

Abstract

Pulmonary alveolar proteinosis (PAP) can be due to primary autoimmune and secondary causes, including e-cigarette, or vaping, product use-associated lung injury. We present a 33-year-old male presenting with PAP and a history of vaping. Serum anti-granulocyte-macrophage colony-stimulating factor antibodies were present. Vitamin E (VE), but not VE acetate, was detected in bronchoalveolar lavage. This is the first report of potential association between vaping and autoimmune PAP.

Keywords: autoimmune; pulmonary alveolar proteinosis; vaping; vitamin E; vitamin E acetate.

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Conflict of interest statement

None declared.

Figures

FIGURE 1
FIGURE 1
(A) Computed tomography scan showing ground‐glass changes with interlobular septal thickening (crazy‐paving pattern). (B) Amorphous globular structures that stained orange to green (arrow) (Papanicolaou stain, original magnification ×400). (C) Numerous lipid‐laden macrophages and droplets of fat in the background (Oil‐Red‐O stain, original magnification ×400). (D) Lamellar bodies (arrow) seen on electron microscopy (original magnification ×15,000)
See this image and copyright information in PMC

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