A 54-year-old woman with a history of recurrent exertional dyspnea for 5 years was admitted for evaluation. Six months prior, she noted a worsening of her symptoms, with progressive physical activity limitation caused by exertional fatigue and dyspnea (climbing 2 to 3 flights of stairs). She also experienced palpitations, with an estimated heart rate that ranged from 120 to 150 beats per minute. The patient denied chest pain, hemoptysis, or other notable symptoms. Notably, the patient underwent surgical repair of an atrial septal defect more than 20 years earlier, with a good postoperative recovery. Regular postoperative echocardiograms revealed no residual shunt, no valvular abnormalities, and no pulmonary hypertension. The patient had no history of smoking, drug abuse, or alcohol consumption.

A 94-year-old man presented with a 1-day history of dyspnea and no infective symptoms. There was no associated chest pain, cough, or fever. Systemic review was negative for loss of appetite or weight. He had a medical history of ischemic heart disease with an ejection fraction of 45%, hypertension, hyperlipidemia, and Alzheimer dementia.

A 47-year-old woman initially presented with recurrent coughing caused by the ingestion of gritty foods such as nuts over 20 years ago. Subsequently, she experienced frequent postprandial episodes of white sputum containing food particles and suffered from acid reflux and heartburn, which were originally overlooked.

Pulmonary alveolar proteinosis (PAP) is a rare lung condition characterized by the accumulation of proteinaceous material within the alveoli. The acquired form is often autoimmune, driven by autoantibodies against granulocyte-macrophage colony-stimulating factor. Presentation of autoimmune PAP may range from incidental detection in asymptomatic patients to advanced respiratory failure. Treatment typically involves whole lung lavage or granulocyte-macrophage colony-stimulating factor therapy in symptomatic patients; spontaneous resolution is rare in severe cases. Here, we report 3 cases of autoimmune PAP who presented with resting hypoxia and exhibited spontaneous resolution without significant treatment. All 3 cases had a history of occupational inhalational exposure to noxious gases, and they improved following sustained cessation of exposure. We hypothesize that occupational or environmental noxious inhalation exposure may have a role in disease expression in some cases of autoimmune PAP, and such cases may show spontaneous resolution following cessation of the offending exposure.

There is increasing recognition that health behaviors may contribute to outcomes following COVID-19, but information on the role of alcohol use is limited.

Identifying biomarkers is vital for interstitial lung disease (ILD) management and prognostication. While anti-Ro52 antibodies are frequently detected in autoimmune diseases, their significance in ILD remains unclear.