A case of autoimmune pulmonary alveolar proteinosis in a patient with chronic nicotine vaping exposure.

Pulmonary alveolar proteinosis (PAP) is a rare diffuse lung disorder characterized by accumulation of lipoproteinaceous surfactant material within alveoli, leading to impaired gas exchange. While autoimmune PAP, mediated by granulocyte/macrophage colony-stimulating factor (GM-CSF) autoantibodies, represents the most common form, emerging environmental exposures have been implicated as potential triggers. Electronic cigarettes (e-cigarette) use, or vaping, has recently been reported in a limited number of cases as a possible contributing factor in the development of PAP. We report a case of PAP in a young woman with a history of chronic vaping exposure, whose diagnostic evaluation confirmed the presence of circulating GM-CSF autoantibodies, supporting an autoimmune process linking the association between vaping and PAP.