Tuesday, January 02, 2007

Follow-up to PAP case

I had posted a while ago on this patient with alveolar changes and a Bx consistent with PAP. We had also initiated a discussion on PAP and anti-GM-CSF antibodies.
I did send the Pt's blood to the Cleveland Clinic and her titers were 1:12,800 (1:400 or less is the usual normal level).
She is still asymptomatic and doing well.
Have you checked anti-GM-CSF ABs in your PAP Pts? Would you start treatment at this point (she is asymptomatic with normal PFTs) or just monitor?

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Anonymous said...

Sponteneous remmsion may occur in a small subset (8%) . [Chest 2007; 131(1): 320] But if she desaturates with exercise/ambulation, I would consider inhaled GM-CSF. [Eur Respir J 2006;27,585]