Infections in autoimmune pulmonary alveolar proteinosis: a large retrospective cohort.
GM-CSF autoantibody
bacterial Infection
opportunist lung infections
pulmonary alveolar proteinosis
Journal
Thorax
ISSN: 1468-3296
Titre abrégé: Thorax
Pays: England
ID NLM: 0417353
Informations de publication
Date de publication:
27 Sep 2023
27 Sep 2023
Historique:
received:
19
01
2023
accepted:
21
08
2023
pubmed:
28
9
2023
medline:
28
9
2023
entrez:
27
9
2023
Statut:
aheadofprint
Résumé
Autoimmune pulmonary alveolar proteinosis (aPAP) is a rare disease, predisposing to an increased risk of infection. A complete picture of these infections is lacking. Describe the characteristics and clinical outcomes of patients diagnosed with aPAP, and to identify risk factors associated with opportunistic infections. We conducted a retrospective cohort including all patients diagnosed with aPAP between 2008 and 2018 in France and Belgium. Data were collected using a standardised questionnaire including demographics, comorbidities, imaging features, outcomes and microbiological data. We included 104 patients, 2/3 were men and median age at diagnosis was 45 years. With a median follow-up of 3.4 years (IQR 1.7-6.6 years), 60 patients (58%), developed at least one infection, including 23 (22%) with opportunistic infections. Patients with aPAP often presented with opportunistic infections, especially nocardiosis, which highlights the importance of systematic search for slow-growing bacteria in bronchoalveolar lavage or whole lung lavage.
Sections du résumé
BACKGROUND
BACKGROUND
Autoimmune pulmonary alveolar proteinosis (aPAP) is a rare disease, predisposing to an increased risk of infection. A complete picture of these infections is lacking.
RESEARCH QUESTION
OBJECTIVE
Describe the characteristics and clinical outcomes of patients diagnosed with aPAP, and to identify risk factors associated with opportunistic infections.
METHODS
METHODS
We conducted a retrospective cohort including all patients diagnosed with aPAP between 2008 and 2018 in France and Belgium. Data were collected using a standardised questionnaire including demographics, comorbidities, imaging features, outcomes and microbiological data.
RESULTS
RESULTS
We included 104 patients, 2/3 were men and median age at diagnosis was 45 years. With a median follow-up of 3.4 years (IQR 1.7-6.6 years), 60 patients (58%), developed at least one infection, including 23 (22%) with opportunistic infections.
INTERPRETATION
CONCLUSIONS
Patients with aPAP often presented with opportunistic infections, especially nocardiosis, which highlights the importance of systematic search for slow-growing bacteria in bronchoalveolar lavage or whole lung lavage.
Identifiants
pubmed: 37758458
pii: thorax-2023-220040
doi: 10.1136/thorax-2023-220040
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: The authors reported no conflict of interest related to this work. SMA reports having received consultancy for board membership, consultancy or speaker fees from AstraZeneca, Boehringer Ingelheim, Novartis and Roche, GSK, BMS, Chiesi and Pfizer; and travel support from Boehringer Ingelheim. Other authors have nothing to disclose.