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Case Reports
. 2023 Aug 1;62(15):2237-2241.
doi: 10.2169/internalmedicine.1592-23. Epub 2023 May 10.

Autoimmune Pulmonary Alveolar Proteinosis That Improved after a COVID-19 Episode

Atsushi Yanagisawa  1 , Takayuki Takimoto  1 , Ryota Shintani  1 , Takehiko Kobayashi  2 , Masaki Hirose  2 , Toru Arai  2 , Yoshikazu Inoue  2
Affiliations
Case Reports

Autoimmune Pulmonary Alveolar Proteinosis That Improved after a COVID-19 Episode

Atsushi Yanagisawa et al. Intern Med. .

Abstract

Autoimmune pulmonary alveolar proteinosis (APAP) is caused by macrophage dysfunction owing to the presence of anti-granulocyte-macrophage colony-stimulating factor (GM-CSF) autoantibodies. A 77-year-old man with APAP was referred to our hospital for whole-lung lavage (WLL) due to oxygenation exacerbation and pulmonary shadows. The patient had had coronavirus disease 2019 (COVID-19) during the APAP evaluation before WLL. About three months after COVID-19 resolved, his oxygenation and shadow reflecting APAP had obviously improved, thus avoiding the need for WLL. We suspected that the improvement in APAP was due to various immunological reactions induced by COVID-19.

Keywords: coronavirus disease 2019 (COVID-19); granulocyte-macrophage colony-stimulating factor (GM-CSF); pulmonary alveolar proteinosis; viral infection.

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Conflict of interest statement

Author's disclosure of potential Conflicts of Interest (COI).

Yoshikazu Inoue: Advisory role, SAVARA.

Figures

Figure.
Figure.
Clinical course. COVID-19: coronavirus disease 2019, mMRC: modified Medical Research Council dyspnea scale, HRCT: high-resolution computed tomography, KL-6: Krebs von den Lungen-6, CEA: carcinoembryonic antigen, CYFRA: cytokeratin 19 fragment, CRP: C-reactive protein. Desaturation on exertion: percutaneous oxygen saturation (SpO2) below 90% during exercise. Desaturation at rest: SpO2 at rest is <90%. All days are counted from the diagnosis of COVID-19.
See this image and copyright information in PMC

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Publication types

Supplementary concepts