Pulmonary alveolar proteinosis associated with ruxolitinib
- Details
- Publication Year 2026-07-28,Volume 19,Issue #7,Page e275429
- Journal Title
- BMJ Case Reports
- Publication Type
- Case report
- Abstract
- Pulmonary alveolar proteinosis (PAP) is a rare condition characterised by impaired alveolar macrophage-mediated surfactant clearance, resulting in the accumulation of lipoproteinaceous material within the alveoli. Secondary PAP has been associated with certain medications. Ruxolitinib, a Janus kinase 1/2 inhibitor has recently been implicated in rare cases of PAP.We report the case of a woman in her early 60s treated with ruxolitinib for chronic pulmonary graft-versus-host disease following an allogeneic haematopoietic stem cell transplant for acute lymphoblastic leukaemia, who developed progressive exertional dyspnoea. High-resolution CT demonstrated a 'crazy paving' pattern, and bronchoalveolar lavage revealed periodic acid-Schiff positive granular material consistent with PAP. Microbiological studies were negative. Ruxolitinib was discontinued with subsequent symptomatic, radiological and lung function improvement.This case highlights ruxolitinib as a potential cause of secondary PAP and emphasises the importance of considering this rare complication in patients who develop new respiratory symptoms while receiving ruxolitinib.
- Publisher
- BMJ
- Keywords
- Humans; Female; Pyrimidines; *Pyrazoles/adverse effects; Nitriles; *Pulmonary Alveolar Proteinosis/chemically induced/diagnostic imaging/diagnosis; Graft vs Host Disease/drug therapy; Tomography, X-Ray Computed; Hematopoietic Stem Cell Transplantation/adverse effects; Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy; Dyspnea; Drug-Related Side Effects and Adverse Reactions; Haematology (incl blood transfusion); Respiratory medicine
- Department(s)
- Internal Medicine; Haematology
- Publisher's Version
- https://doi.org/10.1136/bcr-2026-275429
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2026-08-13 12:12:34
Last Modified: 2026-08-13 12:12:40