{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T18:52:35Z","timestamp":1791226355616,"version":"4.1.0"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100019779","name":"Qatar National Library","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019779","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>A 65-year-old smoker with recent vaping resumption, found to have elevated anti-GM-CSF antibodies suggestive of autoimmune pulmonary alveolar proteinosis (PAP). However, bronchoalveolar lavage and whole lung lavage were inconclusive, raising suspicion for concurrent E-cigarettes or vaping-associated lung injury (EVALI). The patient showed no clinical response to corticosteroids and eventually passed away. Post-mortem pathology confirmed surfactant accumulation and foamy macrophages but also showed features of diffuse alveolar damage. This case underscores the diagnostic and management challenges when PAP and inhalational lung injuries overlap.<\/jats:p>","DOI":"10.1093\/omcr\/omag190","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T11:20:21Z","timestamp":1790335221000},"source":"Crossref","is-referenced-by-count":0,"title":["A diagnostic dilemma: autoimmune pulmonary alveolar Proteinosis unmasked by vaping-induced lung injury"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6189-2784","authenticated-orcid":false,"given":"Mohammed Najdat","family":"Seijari","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, TriHealth, Good Samaritan Hospital , 375 Dixmyth Avenue, Cincinnati, OH 45220, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taraneh","family":"Zamani","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, TriHealth, Good Samaritan Hospital , 375 Dixmyth Avenue, Cincinnati, OH 45220, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Nasser","family":"Affas","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hamad Medical Corporation , Hamad Medical City, Doha,","place":["Qatar"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souwdamini","family":"Sethuram","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, TriHealth, Good Samaritan Hospital , 375 Dixmyth Avenue, Cincinnati, OH 45220, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwa","family":"Alfaraj","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Damascus University , Al-Mazzeh Street, Damascus,","place":["Syria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Umair","family":"Khawar","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, TriHealth, Good Samaritan Hospital , 375 Dixmyth Avenue, Cincinnati, OH 45220,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"2026100514072911900_ref1","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1183\/09059180.00001311","article-title":"Pulmonary alveolar proteinosis","volume":"20","author":"Borie","year":"2011","journal-title":"Eur Respir Rev"},{"key":"2026100514072911900_ref2","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1016\/j.ccm.2016.04.006","article-title":"Pulmonary alveolar Proteinosis syndrome","volume":"37","author":"Suzuki","year":"2016","journal-title":"Clin Chest Med"},{"key":"2026100514072911900_ref3","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1038\/s41572-019-0066-3","article-title":"Pulmonary alveolar proteinosis","volume":"5","author":"Trapnell","year":"2019","journal-title":"Nat Rev Dis Primers"},{"key":"2026100514072911900_ref4","first-page":"597","article-title":"Prevalence and healthcare burden of pulmonary alveolar proteinosis","volume":"154","author":"McCarthy","year":"2018","journal-title":"Chest."},{"key":"2026100514072911900_ref5","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1183\/09031936.00092910","article-title":"Clinical features of secondary pulmonary alveolar proteinosis: pre-mortem cases in Japan","volume":"37","author":"Ishii","year":"2011","journal-title":"Eur Respir J"},{"key":"2026100514072911900_ref6","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1016\/j.autrev.2014.01.046","article-title":"Autoimmune pulmonary alveolar proteinosis: clinical course and diagnostic criteria","volume":"13","author":"Ben-Dov","year":"2014","journal-title":"Autoimmun Rev"},{"key":"2026100514072911900_ref7","doi-asserted-by":"publisher","first-page":"658","DOI":"10.1164\/ajrccm.162.2.9910032","article-title":"Serological diagnosis of idiopathic pulmonary alveolar proteinosis","volume":"162","author":"Kitamura","year":"2000","journal-title":"Am J Respir Crit Care Med"},{"key":"2026100514072911900_ref8","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1097\/MCP.0000000000000982","article-title":"Pulmonary alveolar proteinosis - current and future therapeutical strategies","volume":"29","author":"Jehn","year":"2023","journal-title":"Curr Opin Pulm Med"},{"key":"2026100514072911900_ref9","doi-asserted-by":"publisher","first-page":"1908","DOI":"10.1016\/j.rmed.2011.08.018","article-title":"Pulmonary alveolar proteinosis: new insights from a single-center cohort of 70 patients","volume":"105","author":"Bonella","year":"2011","journal-title":"Respir Med"},{"key":"2026100514072911900_ref10","doi-asserted-by":"publisher","first-page":"1525166","DOI":"10.3389\/fimmu.2025.1525166","article-title":"Inflammatory markers activation associated with vapor or smoke exposure in Wistar rats","volume":"16","author":"Wawryk-Gawda","year":"2025","journal-title":"Front Immunol"},{"key":"2026100514072911900_ref11","doi-asserted-by":"publisher","DOI":"10.1002\/rcr2.864","article-title":"Autoimmune pulmonary alveolar proteinosis with a history of vaping and vitamin E-positive bronchoalveolar lavage","volume":"9","author":"Chua","year":"2021","journal-title":"Respirol Case Rep"},{"key":"2026100514072911900_ref12","doi-asserted-by":"publisher","first-page":"890","DOI":"10.1164\/rccm.202002-0252LE","article-title":"A unique case of secondary pulmonary alveolar proteinosis after e-cigarette, or vaping, product use-associated lung injury","volume":"202","author":"Israel","year":"2020","journal-title":"Am J Respir Crit Care Med"}],"container-title":["Oxford Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/omcr\/article-pdf\/2026\/10\/omag190\/71606026\/omag190.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/omcr\/article-pdf\/2026\/10\/omag190\/71606026\/omag190.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T18:07:33Z","timestamp":1791223653000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/omcr\/article\/doi\/10.1093\/omcr\/omag190\/8865239"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":12,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10,4]]}},"URL":"https:\/\/doi.org\/10.1093\/omcr\/omag190","relation":{},"ISSN":["2053-8855"],"issn-type":[{"value":"2053-8855","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,10]]},"published":{"date-parts":[[2026,10]]},"article-number":"omag190"}}