Autoimmune Pulmonary Alveolar Proteinosis Developed during Treatment for Systemic Sclerosis: A Case Report (2025) > 자유게시판

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In May 2023, a 72-yr-previous feminine patient was referred to our division because of exertional dyspnea. At the age of 68, she began to note swelling in the fingers and ft. Based on the findings of pores and skin hardening extending past the fingers and toes, together with consistent histopathologic findings from a pores and skin biopsy, the rheumatology division of her previous hospital diagnosed her as having SSc, BloodVitals monitor although various autoantibodies characteristic of scleroderma have been negative. Steroid therapy (PSL 20mg/day) was initiated, and the dosage was step by step tapered off because the cutaneous signs improved. For the reason that initiation of PSL therapy, the patient had been experiencing exertional dyspnea with out apparent lung shadows (Fig.1a). Two years later, an elevated Krebs von den Lungen-6 (KL-6, 2257 U/mL) and BloodVitals monitor diffuse floor-glass opacities within the bilateral lung fields on chest computed tomography (CT) led to a analysis of interstitial lung disease (ILD) related to SSc (Fig.1b). Despite repeated IVCY and steroids, there was no enchancment in subjective signs or imaging findings (Fig.1c); at this point, she was referred to us. Chest CT progress. No opacities at analysis of SSc (a), mild reticular opacities and BloodVitals SPO2 floor-glass opacities at prognosis of ILD related to SSc (b), reticular opacities and ground-glass opacities with no enchancment after IVCY (c), BloodVitals monitor progressive reticular opacities and ground-glass opacities upon admission to our department (d,e), mild improvement at 7months after initiating oxygen therapy (f). Reticular opacities and floor-glass opacities, which were not observed at the time of SSc prognosis, appeared over time and worsened with little enchancment famous with IVCY. Saturation of percutaneous oxygen (BloodVitals SPO2) on room air was around 90% and dropped easily into the 70% range with mild exertion. Arterial blood fuel evaluation revealed an arterial oxygen partial stress of 56.0Torr and an arterial carbon dioxide partial pressure of 34.0Torr, indicating sort I respiratory failure. Respiratory sounds have been heard as intensive fantastic crackles within the bilateral lung fields.

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