Pulmonary Alveolar Proteinosis, Barbecue Smoke, and Granulocyte-macrophage Colony-stimulating Factor Therapy

Abstract

Pulmonary alveolar proteinosis is a very rare and unusual lung disorder with a prevalence of 3.7-6.2/10 6 , most commonly seen in middle-aged adults. 1 It is characterized by surfactant phospholipid and protein accumulation due to reduced alveolar macrophage-mediated clearance. 1,2 The cause is usually autoimmune, with antibodies directed against granulocytemacrophage colony-stimulating factor (GM-CSF), which is required for the surfactant clearance. 1,2 Etiology can also be congenital, as well as secondary due to hematologic malignancies, infections, or exposures to inorganic or organic dust. 1 We report a case of autoimmune pulmonary alveolar proteinosis with longstanding exposure to barbecue smoke that had a remarkable response to the GM-CSF.