{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T10:09:06Z","timestamp":1753870146193,"version":"3.41.2"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,5,29]],"date-time":"2019-05-29T00:00:00Z","timestamp":1559088000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology Case Reports"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:p>In this report, we describe an unusual manifestation of pulmonary alveolar proteinosis (PAP). The patient is a 43\u2010year\u2010old non\u2010smoking female without underlying hematologic or auto\u2010immune disorder. Her initial presentation included non\u2010specific respiratory symptoms (exertional dyspnoea and cough), an unremarkable physical examination, a mild elevation in her serum level of lactate dehydrogenase, a mild impairment in the diffusion capacity for carbon monoxide but a normal spirometry, and multiple ground\u2010glass opacities with a \u201ccrazy\u2010paving\u201d pattern predominantly in upper lung zones on her chest radiographic images. PAP was diagnosed histologically. PAP commonly occurs in males with smoking history, and tends to affect the lung parenchyma diffusely or, as in auto\u2010immune PAP, lower lobes predominantly. Upper\u2010lobe predominant PAP, particularly in a non\u2010smoking female, is rare. This report would add PAP to the list of differential diagnosis for upper\u2010lung ground\u2010glass opacities. A review on the relevant literature is also included in the discussion.<\/jats:p>","DOI":"10.1002\/rcr2.445","type":"journal-article","created":{"date-parts":[[2019,5,30]],"date-time":"2019-05-30T00:37:17Z","timestamp":1559176637000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pulmonary alveolar proteinosis with upper\u2010lobe predominance in a non\u2010smoking female"],"prefix":"10.1002","volume":"7","author":[{"given":"Hong\u2010Ping","family":"Er","sequence":"first","affiliation":[{"name":"Division of Chest Medicine, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine National Cheng Kung University  Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chung\u2010Ta","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pathology, National Cheng Kung University Hospital, College of Medicine National Cheng Kung University  Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7675-9561","authenticated-orcid":false,"given":"Tang\u2010Hsiu","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Chest Medicine, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine National Cheng Kung University  Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,5,29]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM195806052582301"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra023226"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clim.2010.02.017"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00001311"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccm.2016.04.006"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20080990"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20080759"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.92.21.9565"},{"key":"e_1_2_4_10_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.162.2.9910032"},{"key":"e_1_2_4_11_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200708-1271OC"},{"key":"e_1_2_4_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1963.03860060164018"},{"key":"e_1_2_4_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-017-0493-4"},{"key":"e_1_2_4_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(12)65477-9"},{"key":"e_1_2_4_15_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.114.5.1357"},{"key":"e_1_2_4_16_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.2109105"},{"key":"e_1_2_4_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2009.01539.x"},{"key":"e_1_2_4_18_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00092910"},{"key":"e_1_2_4_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2011.08.018"},{"key":"e_1_2_4_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/1750-1172-8-40"},{"key":"e_1_2_4_21_1","first-page":"4021928","article-title":"The clinical clues of pulmonary alveolar proteinosis: a report of 11 cases and literature review","author":"Mo Q","year":"2016","journal-title":"Can. 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