{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T16:10:36Z","timestamp":1773418236909,"version":"3.50.1"},"reference-count":5,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology Case Reports"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Pulmonary alveolar proteinosis (PAP) and anti\u2010PL\u20107 antibody\u2010positive interstitial lung disease (ILD) share early radiographic similarities, yet their treatments differ significantly. This article reports a rare case of dual anti\u2010PL\u20107 and anti\u2010GM\u2010CSF autoantibody positivity, initially misdiagnosed as anti\u2010synthetase syndrome due to interstitial infiltrates and concurrent Nocardia\/Aspergillus infections. Empirical glucocorticoid therapy worsened symptoms. Definitive PAP diagnosis was confirmed via milky bronchoalveolar lavage fluid (BALF) and anti\u2010GM\u2010CSF autoantibody detection, alongside incidental pulmonary embolism. Multidisciplinary intervention (antimicrobials, thrombolysis, and whole\u2010lung lavage) improved oxygenation. Clinicians must consider PAP as a differential diagnosis in patients with atypical presentations before commencing immunosuppressive therapy. Multidisciplinary collaboration is crucial for managing complex PAP cases.<\/jats:p>","DOI":"10.1002\/rcr2.70217","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T15:43:22Z","timestamp":1748965402000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic Dilemma in a Case of Anti\u2010<scp>PL<\/scp>\u20107 Antibody\u2010Positive Interstitial Lung Disease: When Autoimmune Alveolar Proteinosis Masquerades as Anti\u2010Synthetase Syndrome"],"prefix":"10.1002","volume":"13","author":[{"given":"Beili","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, The Second Hospital and Clinical Medical School Lanzhou University  Lanzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao","family":"Xu","sequence":"additional","affiliation":[{"name":"The Second Clinical Medical School Lanzhou University  Lanzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuqian","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The Second Hospital and Clinical Medical School Lanzhou University  Lanzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Runze","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, The Second Hospital and Clinical Medical School Lanzhou University  Lanzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danbei","family":"Diwu","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, The Second Hospital and Clinical Medical School Lanzhou University  Lanzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5267-2322","authenticated-orcid":false,"given":"Fanqi","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, The Second Hospital and Clinical Medical School Lanzhou University  Lanzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00725-2024"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00104310"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-015-0085-0"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-022-01909-z"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0b013e318260977c"}],"container-title":["Respirology Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/rcr2.70217","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T15:59:14Z","timestamp":1750953554000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/rcr2.70217"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":5,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1002\/rcr2.70217"],"URL":"https:\/\/doi.org\/10.1002\/rcr2.70217","archive":["Portico"],"relation":{},"ISSN":["2051-3380","2051-3380"],"issn-type":[{"value":"2051-3380","type":"print"},{"value":"2051-3380","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6]]},"assertion":[{"value":"2025-03-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70217"}}