Exacerbation of autoimmune pulmonary alveolar proteinosis that improved with lone treatment of complicating nontuberculous mycobacterial infection: A case report

Shunya Shiohira; Masashi Sakayori; Keiichiro Yoshioka; Hajime Kasai; Ryutaro Hirama; Mitsuhiro Abe; Hiroki Nishimura; Takuji Suzuki

Respiratory Medicine Case Reports (Jan 2021)

Exacerbation of autoimmune pulmonary alveolar proteinosis that improved with lone treatment of complicating nontuberculous mycobacterial infection: A case report

Shunya Shiohira,
Masashi Sakayori,
Keiichiro Yoshioka,
Hajime Kasai,
Ryutaro Hirama,
Mitsuhiro Abe,
Hiroki Nishimura,
Takuji Suzuki

Affiliations

Shunya Shiohira: Department of Medicine, School of Medicine, Chiba University, Chiba, 260-8670 Japan
Masashi Sakayori: Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, 260-8670, Japan
Keiichiro Yoshioka: Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, 260-8670, Japan
Hajime Kasai: Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, 260-8670, Japan; Health Professional Development Center, Chiba University Hospital, Chiba, 260-8670, Japan; Corresponding author: Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, 260-8670, Japan.
Ryutaro Hirama: Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, 260-8670, Japan
Mitsuhiro Abe: Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, 260-8670, Japan
Hiroki Nishimura: Department of Respiratory Medicine, National Hospital Organization Chiba Medical Center, Chiba, 260-0042, Japan
Takuji Suzuki: Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, 260-8670, Japan

Journal volume & issue: Vol. 34
p. 101521

Abstract

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Herein, we present the case of a 63-year-old man with autoimmune pulmonary alveolar proteinosis (APAP) complicated by Mycobacterium avium complex (MAC) infection. APAP was diagnosed based on serum anti-granulocyte-macrophage colony-stimulating factor antibody, bronchoalveolar lavage fluid (BALF) findings, and transbronchial lung biopsy. Nodular shadows with cavities were visible on chest CT images, and Mycobacterium intracellulare was identified by BALF culture. Rifampicin, ethambutol, and clarithromycin were administered, and 4 months later, the nodular shadows of MAC had disappeared, and APAP was remarkably improved. Thus, in cases of APAP exacerbation complicated with infections, such as MAC, control of the infections may improve APAP.

Published in Respiratory Medicine Case Reports

ISSN: 2213-0071 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the respiratory system
Website: http://www.journals.elsevier.com/respiratory-medicine-case-reports/

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Abstract

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