Pulmonary Alveolar Proteinosis with Ulcerative Colitis

Noriho Sakamoto; Shota Nakashima; Hiroshi Ishimoto; Tomoyuki Kakugawa; Atsuko Hara; Hirokazu Yura; Takuto Miyamura; Seiko Nakamichi; Yasushi Obase; Yuji Ishimatsu; Hiroshi Mukae

doi:10.2169/internalmedicine.0555-17

CASE REPORTS

Pulmonary Alveolar Proteinosis with Ulcerative Colitis

Noriho Sakamoto, Shota Nakashima, Hiroshi Ishimoto, Tomoyuki Kakugawa, Atsuko Hara, Hirokazu Yura, Takuto Miyamura, Seiko Nakamichi, Yasushi Obase, Yuji Ishimatsu, Hiroshi Mukae

Author information

Noriho Sakamoto
Department of Respiratory Medicine, Unit of Basic Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan
Shota Nakashima
Department of Respiratory Medicine, Unit of Basic Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan
Hiroshi Ishimoto
Department of Respiratory Medicine, Unit of Basic Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan
Tomoyuki Kakugawa
Department of Respiratory Medicine, Unit of Basic Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan
Atsuko Hara
Department of Respiratory Medicine, Unit of Basic Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan
Hirokazu Yura
Department of Respiratory Medicine, Unit of Basic Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan
Takuto Miyamura
Department of Respiratory Medicine, Unit of Basic Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan
Seiko Nakamichi
Department of General Medicine, Unit of Basic Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan
Yasushi Obase
Department of Respiratory Medicine, Unit of Basic Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan
Yuji Ishimatsu
Department of Health Sciences, Unit of Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan
Hiroshi Mukae
Department of Respiratory Medicine, Unit of Basic Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan

Keywords: anti-GM-CSF antibody, Crohn's disease, inflammatory bowel disease

JOURNAL OPEN ACCESS

2018 Volume 57 Issue 18 Pages 2705-2708

DOI https://doi.org/10.2169/internalmedicine.0555-17

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Abstract

A 65-year-old Japanese man was referred to our hospital for the further assessment of cough and dyspnea. He had a history of ulcerative colitis for which he was receiving treatment. Chest computed tomography showed a crazy-paving pattern. His bronchoalveolar lavage fluid had a milky appearance, and a transbronchial lung biopsy specimen revealed acellular periodic acid-Schiff stain-positive bodies. The serum anti-granulocyte macrophage-colony stimulating factor (GM-CSF) antibody titer was elevated. The diagnosis was autoimmune pulmonary alveolar proteinosis (PAP). There are few reports of autoimmune PAP in patients with ulcerative colitis. Some reports suggest that PAP and inflammatory bowel disease might have a common pathogenesis involving the anti-GM-CSF antibody.

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