Internal medicine 57, 18, 2705 - 2708 (2018).
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




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.