Autoimmune Pulmonary Alveolar Proteinosis Diagnosed after Exposure to a Fire Extinguisher Containing Silica Powder

Intern Med. 2019 Jul 15;58(14):2067-2072. doi: 10.2169/internalmedicine.1557-18. Epub 2019 Apr 17.

Abstract

We herein report a case of autoimmune pulmonary alveolar proteinosis (PAP) diagnosed after one-time exposure to silica powder. Owing to the misuse of a silica-containing fire extinguisher and the inhalation of large amounts of its powder, the patient experienced prolonged cough and visited our hospital. The findings of chest computed tomography and surgical lung biopsy specimens led to the diagnosis of PAP. Interestingly, the presence of anti-GM-CSF antibody was detected; therefore, both autoimmune characteristics and exposure to large amounts of silica may have caused the development of PAP in this patient. This case provides important insight into the mechanisms leading to the onset of PAP.

Keywords: anti-GM-CSF antibody; dust; elemental analysis; fire extinguisher; pulmonary alveolar proteinosis; silica.

Publication types

  • Case Reports

MeSH terms

  • Administration, Inhalation
  • Aged
  • Autoimmune Diseases / chemically induced
  • Autoimmune Diseases / diagnosis
  • Autoimmune Diseases / physiopathology*
  • Environmental Exposure / adverse effects*
  • Female
  • Fire Extinguishing Systems
  • Humans
  • Particulate Matter / adverse effects*
  • Pulmonary Alveolar Proteinosis / chemically induced*
  • Pulmonary Alveolar Proteinosis / diagnosis*
  • Pulmonary Alveolar Proteinosis / physiopathology
  • Silicon Dioxide / adverse effects*

Substances

  • Particulate Matter
  • Silicon Dioxide

Supplementary concepts

  • Pulmonary Alveolar Proteinosis, Acquired