Pulmonary alveolar proteinosis and histoplasmosis

Abstract

Pulmonary alveolar proteinosis (PAP), in addition to acute generalized histoplasmosis, was found at autopsy of three adult males, 23, 51, and 52 years of age. All three patients became ill in the same region of Venezuela, south of Lake Maracaibo, an area considered highly endemic for histoplasmosis. The PAP may be due to an environmental factor.

Emerging clinical phenotypes associated with anti-cytokine autoantibodies

“…Indeed, reduced cell adhesion, phagocytosis, pathogen killing, mannose-and Toll-like receptor expression, and LPS-or peptidoglycan-stimulated TNFα release were observed in alveolar macrophages and neutrophils from GM-CSF deficient mice and PAP patients [31,35]. Accordingly, PAP patients developed respiratory and extrapulmonary infections with opportunistic pathogens such as nontuberculous mycobacteria, Histoplasma, Cryptococcus, Nocardia or fungi [35][36][37][38][39][40]. Notably, this spectrum of infections appears very similar to the phenotype associated with the presence of neutralizing anti-IFNγ AAbs [6].…”

Pulmonary Alveolar Proteinosis

“…103,104 The crazy-paving pattern is not pathognomonic of pulmonary alveolar proteinosis, and occurs in other infectious or non-infectious conditions. [104][105][106][107][108][109][110][111][112][113][114] The subacute or chronic clinical course, absence of architectural distortion, smooth 78 Cryptococcus neoformans 79,80 Mycobacterium tuberculosis [81][82][83][84] Mycobacterium avium-intracellulare 85,86 inter-lobular septal thickening, geographical distribution, and discordance between the clinical and radiological features help differentiate pulmonary alveolar proteinosis from other causes of crazy paving. In a study of 42 patients, Ishii et al 115 reported differences in the pattern and distribution of ground-glass opacity on high-resolution CT, which help to differentiate secondary from autoimmune pulmonary alveolar proteinosis.…”

Pulmonary Alveolar Proteinosis and tuberculosis in a diabetic patient: a rare or a seldom diagnosed association

“…[5][6][7], Mycobacterium sp. [8][9][10][11][12][13], Cryptococcus neoformans [14], Histoplasma capsulatum [15], Pneumocystis carinii [16], and virus [17]. Rarely, cases of PAP may be associated with Mycobacterium tuberculosis [10,13].…”