Kobayashi Takehiko, Arai Toru, Hirose Masaki, Homma Tomomi, Matsumuro Akiko, Sugimoto Chikatoshi, Kitaichi Masanori, Akira Masanori, Inoue Yoshikazu
Department of Internal Medicine.
Clinical Research Center.
Sarcoidosis Vasc Diffuse Lung Dis. 2017;34(1):85-90. doi: 10.36141/svdld.v34i1.5086. Epub 2017 Apr 28.
Pulmonary alveolar proteinosis (PAP) is a rare disease of unknown aetiology. Although resolution occurs in about 30% of autoimmune PAP (APAP) cases, its pathogenesis is not yet sufficiently understood. Two APAP cases at our institute showed remission following infectious episodes. Case 1: a 40-year-old female APAP patient suffered from herpes encephalitis and was treated with an antiviral drug. Her symptoms and radiological results resolved within two months of her recovery from the encephalitis. Case 2: A 53-year-old male current-smoker APAP patient was admitted for pneumonia. After treatment with antibiotics, his radiological results and symptoms improved. He experienced a similar resolution of APAP after another infectious episode two years later. Remission of APAP may occur following viral or bacterial infection. We hypothesise that remission of APAP is triggered by the induction of granulocyte-macrophage colony-stimulating factor (GM-CSF) following viral or bacterial infection. Further studies of APAP remission, and especially of the effects of GM-CSF induction, are needed. .
肺泡蛋白沉积症（PAP）是一种病因不明的罕见疾病。虽然约30%的自身免疫性PAP（APAP）病例可自行缓解，但其发病机制尚未得到充分了解。我院的两例APAP病例在感染性疾病发作后病情缓解。病例1：一名40岁的女性APAP患者患疱疹性脑炎，接受了抗病毒药物治疗。她的症状和影像学结果在从脑炎康复后的两个月内得到缓解。病例2：一名53岁的男性现吸烟者APAP患者因肺炎入院。使用抗生素治疗后，他的影像学结果和症状有所改善。两年后，在另一次感染性疾病发作后，他的APAP病情出现了类似的缓解。APAP可能在病毒或细菌感染后缓解。我们推测，APAP的缓解是由病毒或细菌感染后粒细胞-巨噬细胞集落刺激因子（GM-CSF）的诱导所触发的。需要对APAP的缓解情况，尤其是GM-CSF诱导的影响进行进一步研究。
