Case Report: Pulmonary alveolar proteinosis and fibrosis associated with indium-tin-oxide exposure - Report - MDSpire

Case Report: Pulmonary alveolar proteinosis and fibrosis associated with indium-tin-oxide exposure

  • By

  • Xinyao Li

  • Chuan Shi

  • Qiaoling Chen

  • Jiapeng Zhao

  • Suxia Wang

  • Yunhong Yin

  • Ruie Feng

  • Xinlun Tian

  • Kai-Feng Xu

  • May 18, 2026

  • 0 min

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Clinical Report: Interstitial Lung Disease Linked to Indium-Tin-Oxide Exposure

Overview

This case study presents a 35-year-old male with interstitial lung disease linked to indium-tin-oxide (ITO) exposure, diagnosed as pulmonary alveolar proteinosis (PAP). Despite treatment, the patient's condition progressed to pulmonary fibrosis within four months, highlighting the serious implications of occupational exposure to ITO.

Background

Pulmonary alveolar proteinosis (PAP) is a rare disorder characterized by surfactant accumulation and impaired macrophage function. Secondary PAP can arise from inhalation of toxic substances, including indium compounds like ITO, which are increasingly used in electronics. Understanding the link between ITO exposure and lung disease is crucial for preventing occupational hazards in industries utilizing these materials.

Data Highlights

No numerical data or trial data available in the article.

Key Findings

['A 35-year-old male with a history of ITO exposure developed PAP confirmed by transbronchial lung biopsy.', "Indium levels in the patient's bronchoalveolar lavage fluid and plasma were significantly elevated.", 'Despite undergoing whole-lung lavage, the patient progressed to pulmonary fibrosis within four months.', 'Nintedanib treatment did not significantly slow the decline in lung function.', 'Protective measures are essential for workers exposed to ITO to mitigate the risk of lung diseases.']

Clinical Implications

Healthcare professionals should consider PAP in patients with a history of indium exposure, particularly in occupational settings. Implementing protective measures in workplaces that utilize ITO is critical to prevent respiratory complications and monitor lung function regularly.

Conclusion

This case underscores the need for awareness of the potential respiratory risks associated with ITO exposure and the importance of protective measures in occupational health. Further research is needed to understand the long-term effects of ITO exposure.

Related Resources & Content

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  2. The ASCO Post, 2025 -- Patients With Interstitial Lung Disease Face Elevated Lung Cancer Risk, Study Finds
  3. Clinical Rheumatology, 2025 -- Predictive Factors for Rheumatic Disease in Patients with Interstitial Lung Disease: Clinical, Radiologic, and Serologic Insights
  4. Archives of Toxicology, 2024 -- Gene Expression Profiling in Lung Tissues of Rats Exposed to Indium: Investigating the Potential Involvement of S100 Proteins in Pulmonary Disorders
  5. ERS Diagnosis and Management of Pulmonary Alveolar Proteinosis Guideline Summary - Guideline Central, 2024
  6. CHEST Physician, 2025 -- Phase 3 IMPALA-2 clinical trial shows inhaled molgramostim promising for autoimmune pulmonary alveolar proteinosis
  7. ERS Diagnosis and Management of Pulmonary Alveolar Proteinosis Guideline Summary - Guideline Central
  8. Phase 3 IMPALA-2 clinical trial shows inhaled molgramostim promising for autoimmune pulmonary alveolar proteinosis - CHEST Physician
  9. https://www.mhlw.go.jp/bunya/roudoukijun/anzeneisei42/dl/03.pdf

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