Development of Pulmonary Alveolar Proteinosis in a Patient With Adult-Onset Still Disease Treated With Tocilizumab.

We report a patient with systemic adult-onset Still disease (AOSD) who developed anti-granulocyte-macrophage colony-stimulating factor (GM-CSF)-positive pulmonary alveolar proteinosis (PAP) while using tocilizumab (TCZ), diagnosed by milky white bronchoalveolar lavage fluid (BALF; Figure 1). To our knowledge, this is the first case of PAP in AOSD.