A Rare Occurrence of Pulmonary Alveolar Proteinosis after Lung Transplantation

被引：11

作者：

Albores, Jeffrey ^{[1
]}

Seki, Atsuko ^{[2
]}

Fishbein, Michael C. ^{[2
]}

Abtin, Fereidoun ^{[3
]}

Lynch, Joseph P., III ^{[1
]}

Wang, Tisha ^{[1
]}

Weigt, S. Samuel ^{[1
]}

机构：

[1] Univ Calif Los Angeles, David Geffen Sch Med, Div Pulm & Crit Care Med, Dept Med, Los Angeles, CA 90095 USA

[2] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pathol, Los Angeles, CA 90095 USA

[3] Univ Calif Los Angeles, David Geffen Sch Med, Dept Radiol, Los Angeles, CA 90095 USA

来源：

SEMINARS IN RESPIRATORY AND CRITICAL CARE MEDICINE | 2013年 / 34卷 / 03期

关键词：

lung transplantation; pulmonary alveolar proteinosis; interstitial lung disease; immunosuppression; COLONY-STIMULATING FACTOR; PATHOGENESIS; DISEASE;

D O I：

10.1055/s-0033-1348472

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

We present a case of pulmonary alveolar proteinosis (PAP) initially diagnosed 28-months after left single-lung transplantation for idiopathic pulmonary fibrosis. The diagnosis was based upon the presence of periodic acid-Schiff (PAS)-positive and surfactant immunostain-positive acellular lipoproteinaceous material within alveoli seen on transbronchial biopsy as well as in bronchoalveolar lavage fluid. The patient eventually also displayed a characteristic "crazy paving" pattern on radiographic imaging. Granulocyte macrophage-colony stimulating factor antibodies were negative, consistent with secondary PAP. PAP is a rare interstitial lung disease with only a few reported cases occurring after lung transplantation. The etiology is thought to be related to a defect in macrophage function caused by immunosuppression. Reduced immunosuppression has been associated with stabilization, but not reversal, of the condition in the case reported here. PAP is an exceptionally rare cause of dyspnea and radiographic infiltrates after lung transplantation and may be related to toxicity of immune-suppressive medications.

引用

页码：431 / 437

页数：7

共 25 条

[1]

Bag R., 2003, Journal of Heart and Lung Transplantation, V22, pS139, DOI 10.1016/S1053-2498(02)00898-7

[2]

BEDROSSIAN CWM, 1980, HUM PATHOL, V11, P527

[3] Autoantibodies against granulocyte macrophage colony-stimulating factor are diagnostic for pulmonary alveolar proteinosis [J].