Pulmonary alveolar proteinosis associated with ruxolitinib.

Authors

Rav Sellahewa, Daniel Tan, Maraed Rosa, Renee Manser, Alistair Miller, Jeff Szer, Mary Qian

Published in

BMJ case reports. Volume 19. Issue 7. Jul 28, 2026. Epub Jul 28, 2026.

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.

PMID:
42521432
Bibliographic data and abstract were imported from PubMed on 29 Jul 2026.

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