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

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

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.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Autoantibodies
  • Autoimmune Diseases* / complications
  • COVID-19*
  • Humans
  • Lung
  • Male
  • Pulmonary Alveolar Proteinosis* / therapy
  • Treatment Outcome

Substances

  • Autoantibodies

Supplementary concepts

  • Pulmonary Alveolar Proteinosis, Acquired