Document Detail

Pulmonary alveolar proteinosis and tuberculosis in a diabetic patient: a rare or a seldom diagnosed association?
MedLine Citation:
PMID:  12204186     Owner:  NLM     Status:  MEDLINE    
A case of Pulmonary Alveolar Proteinosis (PAP), in association with tuberculosis, is described in a 35-year-old diabetic patient. Lung biopsy showed an intra-alveolar accumulation of PAS-positive material, and multifocal granulomas compatible with tuberculosis. The bronchoalveolar culture was positive for Mycobacterium tuberculosis. PAP results from an imbalance of the mechanisms that regulate the homeostasis of the surfactant, where specific proteins are involved, especially SP-A and SP-D, the cytokines, IL-10 and GM-CSF, in addition to alveolar macrophages and type-II pneumocytes. Chemotaxis and phagocytic capacity are reduced. PAP and diabetes share several immunological disfunctions that may increase the risk for tuberculosis. Although there are no controlled studies, the diagnosis of PAP in diabetic patients with tuberculosis must be considered.
J L Pereira-Silva; M M M A Marinho; T V B Veloso; J C Coelho JC
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases     Volume:  6     ISSN:  1413-8670     ISO Abbreviation:  Braz J Infect Dis     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-09-02     Completed Date:  2003-01-15     Revised Date:  2007-04-24    
Medline Journal Info:
Nlm Unique ID:  9812937     Medline TA:  Braz J Infect Dis     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  188-95     Citation Subset:  IM    
Pulmonary Service, Professor Jorge Valente Hospital, Salvador.
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MeSH Terms
Diabetes Complications*
Isoniazid / therapeutic use
Mycobacterium tuberculosis / isolation & purification
Pulmonary Alveolar Proteinosis / complications*,  diagnosis
Pyrazinamide / therapeutic use
Rifampin / therapeutic use
Tuberculosis, Pulmonary / complications*,  diagnosis,  drug therapy
Reg. No./Substance:
13292-46-1/Rifampin; 54-85-3/Isoniazid; 98-96-4/Pyrazinamide

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