Abstract
Pulmonary alveolar proteinosis (PAP) is a rare diffuse lung disease characterized by the abnormal accumulation of surfactant in the alveoli. It is classified as primary, secondary, and congenital PAP. Autoimmune PAP falls under the primary group and accounts for nearly 90% of all cases of PAP. These patients are at increased risk for secondary infections with opportunistic organisms. The initial presentation of autoimmune PAP complicated with pulmonary tuberculosis is very rare. A 34-year-old male presented with progressive dyspnea, dry cough, and constitutional symptoms of 4 weeks. On evaluation, his CT chest showed patchy areas of ground-glass opacities with interlobular septal thickening resembling crazy-paving pattern. His bronchoscopy revealed milky BAL, which formed a thick sediment on standing and was positive for Mycobacterium tuberculosis on the CBNAAT test and culture. His laboratory investigations showed raised levels of anti-GM-CSF antibodies. He was diagnosed as case of autoimmune PAP complicated with pulmonary tuberculosis and was started on antitubercular therapy. His symptoms improved with the therapy, and he is currently under regular follow-up at the respiratory outpatient department. This case report highlights the significance of screening for secondary infections in PAP patients both at the time of initial presentation and during follow-up, as treatment of these infections may improve the symptom burden.
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NS1 was responsible for concept, designing, writing of the draft, and final approval, KK and NS2 helped in editing the draft, RC collected relevant data, and AY helped in writing and critically editing the draft.
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Sharma, N., Kumar, K., Singh, N. et al. A Rare Case of Autoimmune Pulmonary Alveolar Proteinosis Complicated with Pulmonary Tuberculosis — a Case Report. SN Compr. Clin. Med. 5, 130 (2023). https://doi.org/10.1007/s42399-023-01469-1
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DOI: https://doi.org/10.1007/s42399-023-01469-1