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- Title
Clinical significance of cigarette smoking and dust exposure in pulmonary alveolar proteinosis: a Korean national survey.
- Authors
Ji An Hwang; Joo Han Song; Jung Hoon Kim; Man Pyo Chung; Dong Soon Kim; Jin Woo Song; Young Whan Kim; Sun Mi Choi; Seung Ick Cha; Soo Taek Uh; Choon-Sik Park; Sung Hwan Jeong; Yong Bum Park; Hong Lyeol Lee; Jong Wook Shin; Eun Joo Lee; Yangjin Jegal; Hyun Kyung Lee; Jong Sun Park; Moo Suk Park
- Abstract
<bold>Background: </bold>This study aimed to investigate clinical characteristics of Korean PAP patients and to examine the potential risk factors of PAP.<bold>Methods: </bold>We retrospectively reviewed medical records of 78 Korean PAP patients diagnosed between 1993 and 2014. Patients were classified into two groups according to the presence/absence of treatment (lavage). Clinical and laboratory features were compared between the two groups.<bold>Results: </bold>Of the total 78 PAP patients, 60% were male and median age at diagnosis was 47.5 years. Fifty three percent were ever smokers (median 22 pack-years) and 48% had a history of dust exposure (metal 26.5%, stone or sand 20.6%, chemical or paint 17.7%, farming dust 14.7%, diesel 14.7%, textile 2.9%, and wood 2.9%). A history of cigarette smoking or dust exposure was present in 70.5% of the total PAP patients, with 23% having both of them. Patients who underwent lavage (n = 38) presented symptoms more frequently (38/38 [100%] vs. 24/40 [60%], P < 0.001) and had significantly lower PaO2 and DLCO with higher D(A-a)O2 at the onset of disease than those without lavage (n = 40) (P = 0.006, P < 0.001, and P = 0.036, respectively). Correspondingly, the distribution of disease severity score (DSS) differed significantly between the two groups (P = 0.001). Based on these, when the total patients were categorized according to DSS (low DSS [DSS 1-2] vs. high DSS [DSS 3-5]), smoking status differed significantly between the two groups with the proportion of current smokers significantly higher in the high DSS group (11/22 [50%] vs. 7/39 [17.9%], P = 0.008). Furthermore, current smokers had meaningfully higher DSS and serum CEA levels than non-current smokers (P = 0.011 and P = 0.031), whereas no difference was found between smokers and non-smokers. Regarding type of exposed dust, farming dust was significantly associated with more severe form of PAP (P = 0.004).<bold>Conclusion: </bold>A considerable proportion of PAP patients had a history of cigarette smoking and/or dust exposure, suggestive of their possible roles in the development of PAP. Active cigarette smoking at the onset of PAP is associated with the severity of PAP.
- Subjects
CIGARETTE smoke; ELECTRONIC cigarettes; PULMONARY alveolar proteinosis; HEALTH; SMOKING; HEALTH of cigarette smokers
- Publication
BMC Pulmonary Medicine, 2017, Vol 17, p1
- ISSN
1471-2466
- Publication type
journal article
- DOI
10.1186/s12890-017-0493-4