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
Clinical Scorecard: Case Study: Interstitial Lung Disease Linked to Indium-Tin-Oxide Exposure and Pulmonary Alveolar Proteinosis
At a Glance
Category Detail
Condition Pulmonary Alveolar Proteinosis (PAP) Key Mechanisms Excessive accumulation of surfactant material and dysfunction of alveolar macrophages. Target Population Workers exposed to Indium-Tin-Oxide (ITO), particularly in solar panel processing. Care Setting Clinical evaluation and treatment in a specialized medical facility.
Key Highlights
PAP can be secondary to inhalation of toxic substances like ITO. Case involved a 35-year-old male with a history of ITO exposure and progressive pulmonary fibrosis. Diagnostic confirmation through bronchoalveolar lavage and transbronchial lung biopsy. Nintedanib showed no significant effect on lung function decline. Protective measures are crucial for workers to prevent lung diseases associated with ITO. Guideline-Based Recommendations
Diagnosis
Consider PAP diagnosis in patients with a history of indium exposure. Use bronchoalveolar lavage and transbronchial lung biopsy for confirmation. Management
Whole-lung lavage may be considered as a treatment option. Monitoring & Follow-up
Regular pulmonary function tests and imaging to assess disease progression. Risks
Poor prognosis associated with lung diseases caused by ITO exposure. Patient & Prescribing Data
Individuals with occupational exposure to ITO, particularly in electronics manufacturing.
Limited efficacy of Nintedanib in slowing lung function decline in this case.
Clinical Best Practices
Implement protective measures for workers handling ITO. Educate patients on the risks associated with ITO exposure. Related Resources & Content
