TY - JOUR T1 - Relationship Between Diffuse Pulmonary Fibrosis, Alveolar Proteinosis, and Granulocyte-Macrophage Colony Stimulating Factor Autoantibodies JF - Respiratory Care SP - 1608 LP - 1610 DO - 10.4187/respcare.01054 VL - 56 IS - 10 AU - Maurizio Luisetti AU - Pierdonato Bruno AU - Zamir Kadija AU - Takuji Suzuki AU - Salvatore Raffa AU - Maria Rosaria Torrisi AU - Ilaria Campo AU - Francesca Mariani AU - Ernesto Pozzi AU - Bruce C Trapnell AU - Salvatore Mariotta Y1 - 2011/10/01 UR - http://rc.rcjournal.com/content/56/10/1608.abstract N2 - Extensive pulmonary fibrosis is a rare occurrence in pulmonary alveolar proteinosis. We report 2 cases that have interesting implications. A female patient was diagnosed with autoimmune pulmonary alveolar proteinosis that evolved over 7 years into diffuse fibrosis. In a male patient with diffuse fibrosis we incidentally detected electron microscopic features of alveolar surfactant accumulation and positive autoantibodies to granulocyte-macrophage colony stimulating factor. In the male patient we speculated that the pulmonary fibrosis might have been preceded by an asymptomatic phase of autoimmune pulmonary alveolar proteinosis, and that we should investigate the involvement of surfactant dysfunction in the pathogenesis of fibrotic lung disease. ER -