Pulmonary alveolar proteinosis (PAP) is a rare lung disorder in which defects in alveolar macrophage maturation or function\nlead to the accumulation of proteinaceous surfactant in alveolar space, resulting in impaired gas exchange and hypoxemia.\nPAP is categorized into three types: hereditary, autoimmune, and secondary. We report a case of secondary PAP in a 47-yearold\nman, whose risk factors include occupational exposure to inhaled toxins, especially aluminum dust, the use of anabolic\nsteroids, and alcohol abuse, which in mice leads to alveolar macrophage dysfunction through a zinc-dependent mechanism that\ninhibits granulocyte macrophage-colony stimulating factor (GM-CSF) receptor signalling. Although the rarity and vague clinical\npresentation of PAP can pose diagnostic challenges, clinician awareness of PAP risk factors may facilitate the diagnostic process\nand lead to more prompt treatment.
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