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Hara A, Kishimoto Y, Shirai T, Murakami A, Suzuki M, Matsubara O. An autopsy case of acute fibrinous and organizing pneumonia with periorbital MRSA cellulitis and rheumatoid arthritis. Respirol Case Rep 2024; 12:e01313. [PMID: 38420114 PMCID: PMC10898955 DOI: 10.1002/rcr2.1313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/20/2024] [Indexed: 03/02/2024] Open
Abstract
This case report details a 78-year-old male with periorbital Methicillin-resistant Staphylococcus aureus (MRSA) cellulitis whose condition rapidly deteriorated despite treatment. An autopsy confirmed acute fibrinous and organizing pneumonia (AFOP), revealing fibrin ball formation and organizing pneumonia. While both idiopathic and secondary AFOP cases often exhibit bilateral consolidation on CT, our patient presented with ground-glass opacities, which are frequently associated with secondary AFOP. Notably, secondary AFOP, linked to higher mortality, can result from various factors. In this case, well-controlled rheumatoid arthritis and prolonged oral medication use suggest bilateral periorbital MRSA cellulitis as a significant factor. The study underscores AFOP's diagnostic challenges and the necessity for further research on effective treatments.
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Affiliation(s)
- Akihiro Hara
- Department of Respiratory MedicineShizuoka General HospitalShizuokaJapan
| | - Yutaro Kishimoto
- Department of Respiratory MedicineShizuoka General HospitalShizuokaJapan
| | - Toshihiro Shirai
- Department of Respiratory MedicineShizuoka General HospitalShizuokaJapan
| | | | - Makoto Suzuki
- Department of PathologyShizuoka General HospitalShizuokaJapan
| | - Osamu Matsubara
- Department of PathologyHiratsuka Kyosai HospitalHiratsukaJapan
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Chong WH, Saha BK, Chopra A. Does COVID-19 pneumonia signify secondary organizing pneumonia?: A narrative review comparing the similarities between these two distinct entities. Heart Lung 2021; 50:667-674. [PMID: 34098237 PMCID: PMC8164344 DOI: 10.1016/j.hrtlng.2021.04.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/07/2021] [Accepted: 04/12/2021] [Indexed: 12/16/2022]
Abstract
Multiple observational studies have described the similarities between COVID-19 pneumonia and organizing pneumonia (OP). These two entities clinically manifest with mild and subacute respiratory symptoms, often with a delayed diagnosis due to the atypical ARDS and silent hypoxemia presentation. Radiological features are often indistinguishable between the two. With the increase in antemortem lung biopsies and autopsies being performed, more histopathological findings of OP and its variant, acute fibrinous and organizing pneumonia (AFOP), are being diagnosed. These entities are known complications of viral infections as a delayed immunological process, explaining the favorable response to corticosteroids. Clinicians should be vigilant to diagnose this under-recognized entity of secondary OP in people with COVID-19 when clinical deterioration occurs, especially with compatible radiologic findings and recent cessation of corticosteroids. Despite the proven benefits of corticosteroids in treating COVID-19, treatment approaches can be more effective as OP often requires higher doses and a more prolonged therapy duration for remission and preventing relapses. The purpose of our narrative review is to compare the similarities between COVID-19 pneumonia and OP, emphasizing the clinical, radiological, and histopathological features based on the evidence available in the literature.
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Affiliation(s)
- Woon H Chong
- Department of Pulmonary and Critical Care Medicine, Albany Medical Center, 43 New Scotland Avenue, Albany 12208, New York, USA.
| | - Biplab K Saha
- Department of Pulmonary and Critical Care, Ozarks Medical Center, West Plains, Missouri, USA
| | - Amit Chopra
- Department of Pulmonary and Critical Care Medicine, Albany Medical Center, 43 New Scotland Avenue, Albany 12208, New York, USA
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Merdji H, Mayeur S, Schenck M, Oulehri W, Clere-Jehl R, Cunat S, Herbrecht JE, Janssen-Langenstein R, Nicolae A, Helms J, Meziani F, Chenard MP. Histopathological features in fatal COVID-19 acute respiratory distress syndrome. Med Intensiva 2021; 45:261-270. [PMID: 34054173 PMCID: PMC7914021 DOI: 10.1016/j.medin.2021.02.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 02/05/2021] [Indexed: 12/15/2022]
Abstract
Background COVID-19 acute respiratory distress syndrome (ARDS) shares the common histological hallmarks with other forms of ARDS. However, the chronology of the histological lesions has not been well established. Objective To describe the chronological histopathological alterations in the lungs of patients with COVID-19 related ARDS. Design A prospective cohort study was carried out. Setting Intensive Care Unit of a tertiary hospital. Patients The first 22 consecutive COVID-19 deaths. Measurements Lung biopsies and histopathological analyses were performed in deceased patients with COVID-19 related ARDS. Clinical data and patient course were evaluated. Results The median patient age was 66 [63-74] years; 73% were males. The median duration of mechanical ventilation was 17 [8-24] days. COVID-19 induced pulmonary injury was characterized by an exudative phase in the first week of the disease, followed by a proliferative/organizing phase in the second and third weeks, and finally an end-stage fibrosis phase after the third week. Viral RNA and proteins were detected in pneumocytes and macrophages in a very early stage of the disease, and were no longer detected after the second week. Limitation Limited sample size. Conclusions The chronological evolution of COVID-19 lung histopathological lesions seems to be similar to that seen in other forms of ARDS. In particular, lung lesions consistent with potentially corticosteroid-sensitive lesions are seen.
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Key Words
- ACE2, angiotensin-converting enzyme 2
- AFOP, acute fibrinous and organizing pneumonia
- ARDS, acute respiratory distress syndrome
- COVID-19
- COVID-19 related acute respiratory distress syndrome
- COVID-19, coronavirus infectious disease
- DAD, diffuse alveolar damage
- HE, hematoxylin–eosin
- Histopathology
- ISH, in situ hybridization
- NMBD, neuromuscular blocking drugs
- RT-PCR, Reverse Transcriptase-Polymerase chain reaction
- SAPSII, simplified acute physiology score
- SARS-CoV-2
- SOFA, Sequential Organ Failure Assessment
- VILI, ventilator induced lung injury
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Affiliation(s)
- H Merdji
- Service de Médecine Intensive - Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France
| | - S Mayeur
- Département de Pathologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - M Schenck
- Service de Médecine Intensive - Réanimation, Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - W Oulehri
- Service d'Anesthésie - Réanimation Chirurgicale, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg, France
| | - R Clere-Jehl
- Service de Médecine Intensive - Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg, France
| | - S Cunat
- Service de Médecine Intensive - Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - J-E Herbrecht
- Service de Médecine Intensive - Réanimation, Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - R Janssen-Langenstein
- Service de Médecine Intensive - Réanimation, Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - A Nicolae
- Département de Pathologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - J Helms
- Service de Médecine Intensive - Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg, France
| | - F Meziani
- Service de Médecine Intensive - Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France
| | - M-P Chenard
- Département de Pathologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Centre de Ressources biologiques, Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
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Merdji H, Mayeur S, Schenck M, Oulehri W, Clere-Jehl R, Cunat S, Herbrecht JE, Janssen-Langenstein R, Nicolae A, Helms J, Meziani F, Chenard MP. Histopathological features in fatal COVID-19 acute respiratory distress syndrome. Med Intensiva 2021; 45:261-270. [PMID: 34059216 PMCID: PMC8161799 DOI: 10.1016/j.medine.2021.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 02/05/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND COVID-19 acute respiratory distress syndrome (ARDS) shares the common histological hallmarks with other forms of ARDS. However, the chronology of the histological lesions has not been well established. OBJECTIVE To describe the chronological histopathological alterations in the lungs of patients with COVID-19 related ARDS. DESIGN A prospective cohort study was carried out. SETTING Intensive Care Unit of a tertiary hospital. PATIENTS The first 22 consecutive COVID-19 deaths. MEASUREMENTS Lung biopsies and histopathological analyses were performed in deceased patients with COVID-19 related ARDS. Clinical data and patient course were evaluated. RESULTS The median patient age was 66 [63-74] years; 73% were males. The median duration of mechanical ventilation was 17 [8-24] days. COVID-19 induced pulmonary injury was characterized by an exudative phase in the first week of the disease, followed by a proliferative/organizing phase in the second and third weeks, and finally an end-stage fibrosis phase after the third week. Viral RNA and proteins were detected in pneumocytes and macrophages in a very early stage of the disease, and were no longer detected after the second week. LIMITATION Limited sample size. CONCLUSIONS The chronological evolution of COVID-19 lung histopathological lesions seems to be similar to that seen in other forms of ARDS. In particular, lung lesions consistent with potentially corticosteroid-sensitive lesions are seen.
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Affiliation(s)
- H Merdji
- Service de Médecine Intensive - Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France
| | - S Mayeur
- Département de Pathologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - M Schenck
- Service de Médecine Intensive - Réanimation, Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - W Oulehri
- Service d'Anesthésie - Réanimation Chirurgicale, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg, France
| | - R Clere-Jehl
- Service de Médecine Intensive - Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg, France
| | - S Cunat
- Service de Médecine Intensive - Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - J-E Herbrecht
- Service de Médecine Intensive - Réanimation, Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - R Janssen-Langenstein
- Service de Médecine Intensive - Réanimation, Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - A Nicolae
- Département de Pathologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - J Helms
- Service de Médecine Intensive - Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg, France
| | - F Meziani
- Service de Médecine Intensive - Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France.
| | - M-P Chenard
- Département de Pathologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Centre de Ressources biologiques, Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
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Time to consider histologic pattern of lung injury to treat critically ill patients with COVID-19 infection. Intensive Care Med 2020; 46:1124-1126. [PMID: 32328726 PMCID: PMC7178098 DOI: 10.1007/s00134-020-06057-8] [Citation(s) in RCA: 248] [Impact Index Per Article: 49.6] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2020] [Indexed: 11/30/2022]
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Abstract
RATIONALE Acute fibrinous and organizing pneumonia (AFOP) is a newly evolving rare non-infectious lung pathology, characterized by intra-alveolar fibrin balls on histology. It is usually difficult to be diagnosed and mistaken for other lung diseases. PATIENT CONCERNS In this article, an interesting case about a male patient with a 15-day history of high-grade fever, chills, and no productive cough was presented. He was misdiagnosed as the lung infection early, but exhibited no response to the antibiotic therapy. DIAGNOSIS The diagnosis of AFOP was determined by the lung biopsy and pathology. INTERVENTIONS With the diagnosis of AFOP, all antibiotics were discontinued, and 40 mg methylprednisolone daily was given intravenously. OUTCOMES The patient responded well to the treatment with steroids. LESSONS AFOP is a rare lung disease characterized by bilateral basilar infiltrates and histological findings of organizing pneumonia and intra-alveolar fibrin in the form of "fibrin balls". Lung biopsy and histopathology were the most important diagnostic methods for the AFOP. Glucocorticoid was an effective drug for the treatment. Subacute patients of AFOP have excellent prognosis with corticosteroids.
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Affiliation(s)
- Kaige Wang
- Department of Respiratory and Critical Care Medicine
| | - Xinmiao Du
- Department of Respiratory and Critical Care Medicine
| | - Qian Wu
- Department of Pathology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Deyun Cheng
- Department of Respiratory and Critical Care Medicine
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Huang T, Zhang Y, Wang C, Gao J. Propofol reduces acute lung injury by up-regulating gamma-aminobutyric acid type a receptors. Exp Mol Pathol 2019; 110:104295. [PMID: 31419406 DOI: 10.1016/j.yexmp.2019.104295] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 07/11/2019] [Accepted: 08/12/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND We used a two-hit lung injury rat model that involves mechanical ventilation (MV) following lipopolysaccharide exposure to investigate the effects of propofol on the expression of GABAA receptors (GABAAR) and cytokine responses, and we then determined the specific effects of GABA on cytokine responses in vitro in alveolar epithelial cells (AECs). METHODS Forty-eight adult male Wister rats were equally and randomly divided into the following 4 groups (n = 12) using a random number table: sham group, sham+propofol group, lipopolysaccharide (LPS) + VILI group, and LPS + VILI + propofol group. All animals were anesthetized, and the animals received a 3.75 mg/kg intratracheal instillation of endotoxins or phosphate-buffered saline (PBS) as the control, as described previously. After 30 min, rats were ventilated for 5 h in a volume-controlled ventilation mode. In the LPS + VILI group, animals were ventilated with a tidal volume (Vt) of 22 ml/kg and zero positive end-expiratory pressure (PEEP) at a respiratory rate of 16-18 breaths/min, whereas control (sham) rats were ventilated with a Vt of 6 ml/kg and PEEP of 5 cmH2O at a rate of 45-55 breaths/min. The FiO2 remained constant as 0.4, propofol was administered intravenously in the LPS + VILI + propofol and sham + propofol groups at a rate of 10 mg·kg-1·h-1 while normal saline at the same rate was intravenously administered in the LPS + VILI and sham groups during the entire mechanical ventilation period. Five hours after mechanical ventilation, the rats were killed. Survival rates, histopathology, concentrations of inflammatory mediators in bronchoalveolar lavage fluid (BALF), wet weight/dry weight (W/D) ratio of the lung, myeloperoxidase (MPO) activity in lung tissues, and expression of GAD and GABAAR by immunohistochemical detection and Western blotting were assessed. Then, human type II-like alveolar epithelial cells (A549 cells) were cultured to full confluence and incubated with GABA (100 nM) alone, picrotoxin alone, a GABAAR antagonist (PTX, 50 nM), or GABA + PTX for 10 min, followed by stimulation with LPS (control) at 100 ng/ml for 4 h. The concentrations of IL-1β, IL-2, IL-8, and IL-10 were then measured. RESULTS Administration of propofol in a two-hit lung injury rat model can increase survival rates and the expression of GAD and GABAAR (P < .05). The administration of propofol can attenuate the release of pro-inflammatory cytokines both in vivo and in vitro, and the administration of propofol can attenuate histopathological changes, the W/D ratio, and MPO activity (P < .05). CONCLUSIONS In this study, we found that the administration of propofol improved lung function, alleviated lung injury, and up-regulated the GAD and GABAAR expressions in a two-hit model of acute lung injury (ALI) characterized by intratracheal instillation of an endotoxin and prolonged MV. Therefore, the protective effects of propofol may be associated with the up-regulation of GABAA receptors in AECs.
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Affiliation(s)
- Tianfeng Huang
- Department of Anesthesiology, Clinical Medical College of Yangzhou University, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu Province, PR China
| | - Yang Zhang
- Department of Anesthesiology, Clinical Medical College of Yangzhou University, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu Province, PR China
| | - Cunjin Wang
- Department of Anesthesiology, Clinical Medical College of Yangzhou University, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu Province, PR China
| | - Ju Gao
- Department of Anesthesiology, Clinical Medical College of Yangzhou University, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu Province, PR China.
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Ning YJ, Ding PS, Ke ZY, Zhang YB, Liu RY. Successful steroid treatment for acute fibrinous and organizing pneumonia: A case report. World J Clin Cases 2018; 6:1053-1058. [PMID: 30568963 PMCID: PMC6288515 DOI: 10.12998/wjcc.v6.i15.1053] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/30/2018] [Accepted: 11/01/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Since the acute fibrinous and organizing pneumonia (AFOP) was first described by Beasley in 2002, some case reports of patients aged from 38 d to 80 years have been published worldwide, but there is still no standard therapy for this disease and the treatment methods remain controversial. Both steroid and immunosuppressive agents, such as cyclophosphamide or mycophenolate mofetil, have been reported to be effective in some studies, but with many side effects, especially in patients of advanced age.
CASE SUMMARY We herein report an 81-year-old female patient who was admitted to our hospital due to dry cough, and breathlessness for 1 mo. She was treated with broad-spectrum antibiotics and anti-fungal therapy, but without improvement in both symptoms and radiological findings, and her respiratory status worsened, and she required bed rest almost the whole day. Computed tomography-guided percutaneous needle lung biopsy was performed and histopathology examination confirmed the diagnosis of AFOP. She was then successfully treated with a steroid monotherapy, which resulted in a satisfactory clinical outcome without serious complications.
CONCLUSION We conclude that complete remission of AFOP can be achieved by steroid monotherapy in patients of advanced age.
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Affiliation(s)
- Ya-Jing Ning
- Department of Geriatric Respiratory and Critical Care, the First Affiliated Hospital of Anhui Medical University, Hefei 230000, Anhui Province, China
| | - Pei-Shan Ding
- Department of Geriatric Respiratory and Critical Care, the First Affiliated Hospital of Anhui Medical University, Hefei 230000, Anhui Province, China
| | - Zhang-Yan Ke
- Department of Geriatric Respiratory and Critical Care, the First Affiliated Hospital of Anhui Medical University, Hefei 230000, Anhui Province, China
| | - Yan-Bei Zhang
- Department of Geriatric Respiratory and Critical Care, the First Affiliated Hospital of Anhui Medical University, Hefei 230000, Anhui Province, China
| | - Rong-Yu Liu
- Department of Geriatric Respiratory and Critical Care, the First Affiliated Hospital of Anhui Medical University, Hefei 230000, Anhui Province, China
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Wang Y, Zhao S, Du G, Ma S, Lin Q, Lin J, Zheng K, Zhang G, Matucci-Cerinic M. Acute fibrinous and organizing pneumonia as initial presentation of primary Sjögren's syndrome: a case report and literature review. Clin Rheumatol 2018; 37:2001-2005. [PMID: 29717396 DOI: 10.1007/s10067-018-4128-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 04/19/2018] [Accepted: 04/24/2018] [Indexed: 02/05/2023]
Abstract
Acute fibrinous and organizing pneumonia (AFOP) is a new histopathological pattern of acute lung injury first described by Beasley et al. in 2002. Hallmarks of pathological findings are characterized by the presence of intra-alveolar fibrin in the form of fibrin "balls" within the alveolar spaces and organizing pneumonia with a patchy distribution. Patients with AFOP may have an acute or subacute clinical presentation. Although the pathogenesis of AFOP is not fully elucidated, it may be associated with autoimmune diseases. Reported herein is a patient diagnosed of acute AFOP associated with primary Sjögren's syndrome. The patient's condition promptly improved after treatment with corticosteroid.
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Affiliation(s)
- Yukai Wang
- Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou, Guangdong, China.
- Department of Experimental and Clinical Medicine, Department of Geriatric Medicine, Division of Rheumatology, AOUC, University of Florence, Florence, Italy.
| | - Shucan Zhao
- Department of Respiratory Disease, Shantou Central Hospital, Shantou, Guangdong, China
| | - Guangzhou Du
- Department of Radiology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Songkun Ma
- Department of Respiratory Disease, Shantou Central Hospital, Shantou, Guangdong, China
| | - Qisheng Lin
- Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Jianqun Lin
- Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Kedi Zheng
- Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Guohong Zhang
- Department of Pathology, Shantou University Medical College, Shantou, Guangdong, China
| | - Marco Matucci-Cerinic
- Department of Experimental and Clinical Medicine, Department of Geriatric Medicine, Division of Rheumatology, AOUC, University of Florence, Florence, Italy
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Dai JH, Li H, Shen W, Miao LY, Xiao YL, Huang M, Cao MS, Wang Y, Zhu B, Meng FQ, Cai HR. Clinical and Radiological Profile of Acute Fibrinous and Organizing Pneumonia: A Retrospective Study. Chin Med J (Engl) 2016; 128:2701-6. [PMID: 26481733 PMCID: PMC4736875 DOI: 10.4103/0366-6999.167293] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: Acute fibrinous and organizing pneumonia (AFOP) is a unique pathological entity with intra-alveolar fibrin in the form of “fibrin balls” and organizing pneumonia. It was divided into rare idiopathic interstitial pneumonia according to the classification notified by American Thoracic Society/European Respiratory Society in 2013. As a rare pathological entity, it is still not well known and recognized by clinicians. We reviewed the clinical features of 20 patients with AFOP diagnosed in a teaching hospital. Methods: The medical records of 20 patients with biopsy-proven diagnosis of AFOP were retrospectively reviewed. The patients’ symptoms, duration of the disease, comorbidities, clinical laboratory data, pulmonary function testing, radiographic studies, and the response to treatment were extracted and analyzed. Results: Fever was the most common symptom and was manifested in 90% of AFOP patients. For clinical laboratory findings, systematic inflammatory indicators, including C-reactive protein and erythrocyte sedimentation rate, were significantly higher than normal in AFOP patients. In accordance with this increased indicators, injured liver functions were common in AFOP patients. Inversely, AFOP patients had worse clinical conditions including anemia and hypoalbuminemia. For pulmonary function testing, AFOP patients showed the pattern of restrictive mixed with obstructive ventilation dysfunction. For high-resolution computerized tomography (HRCT) findings, the most common pattern for AFOP patients was lobar consolidation which was very similar to pneumonia. However, unlike pneumonia, AFOP patients responded well to glucocorticoids. Conclusion: Patients with AFOP manifest as acute inflammatory-like clinical laboratory parameters and lobar consolidation on HRCT, but respond well to steroid.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Hou-Rong Cai
- Department of Respiratory Medicine, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210008, China
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Rival G, Millet O, Capellier G. [Extracorporeal CO 2 removal as life support system for a severe organizing pneumonia]. REVUE DE PNEUMOLOGIE CLINIQUE 2016; 72:373-376. [PMID: 27836209 DOI: 10.1016/j.pneumo.2016.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 09/19/2016] [Accepted: 09/24/2016] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Acute lung injuries are usually found in intensive care unit. The diffuse alveolar damage (DAD) is the associated histological pattern and the most severe end-stage of the disease. Organizing pneumonia (OP), for which corticosteroids are the reference therapy, can mimic DAD. While postponing the response to treatment, to limit mechanical ventilation side effects, extracorporeal membrane oxygene can be proposed. We present a case of a severe OP for which extracorporeal CO2 removal (ECCO2R) is used as a bridge to recovery under corticosteroid therapy. CASE REPORT In the context of a flu-like syndrome, the non-recovery of a lung impairment is reported to a severe OP. ECCO2R is applied when using an ultraprotective ventilation and while waiting for lung healing under corticosteroid. This strategy allowed successful recovery, early physical therapy and active mobilization. CONCLUSION This observation presents the diagnostic and therapeutic difficulties of the lung parenchymental disease in intensive care. OP must be recognized. ECCO2R can be used in severe OP as a bridge to recovery while waiting for the corticosteroid efficacy.
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Affiliation(s)
- G Rival
- Service de réanimation polyvalente, centre hospitalier de Montélimar, quartier Beausseret, BP 249, 26200 Montélimar, France; Service de pneumologie, centre hospitalier de Montélimar, quartier Beausseret, BP 249, 26200 Montélimar, France.
| | - O Millet
- Service de réanimation polyvalente, centre hospitalier de Montélimar, quartier Beausseret, BP 249, 26200 Montélimar, France
| | - G Capellier
- Service de réanimation médicale adulte, pôle urgences-SAMU-réanimation, centre hospitalier régional universitaire, 4, boulevard Fleming, 25000 Besançon, France
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12
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Nguyen LP, Ahdoot S, Sriratanaviriyakul N, Zhang Y, Stollenwerk N, Schivo M, Harper R. Acute Fibrinous and Organizing Pneumonia Associated With Allogenic Hematopoietic Stem Cell Transplant Successfully Treated With Corticosteroids: A Two-Patient Case Series. J Investig Med High Impact Case Rep 2016; 4:2324709616643990. [PMID: 27152316 PMCID: PMC4843051 DOI: 10.1177/2324709616643990] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 03/15/2016] [Accepted: 03/16/2016] [Indexed: 11/16/2022] Open
Abstract
Acute fibrinous and organizing pneumonia (AFOP) is an extremely rare, relatively new, and distinct histological pattern of acute lung injury characterized predominately by the presence of intra-alveolar fibrin and associated organizing pneumonia. AFOP may be idiopathic or associated with a wide spectrum of clinical conditions. It has a variable clinical presentation from mild respiratory symptoms to that similar to the acute respiratory distress syndrome. Currently there is no consensus on treatment, and corticosteroids previously were of unclear benefit. To date, there are less than 40 cases of AFOP reported in the literature and only one has been linked to hematopoietic stem cell transplantation. Here we report the first case series of 2 patients who developed AFOP following allogenic stem cell transplant that were successfully treated with high-dose corticosteroids.
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Affiliation(s)
- Lam-Phuong Nguyen
- University of California, Davis, CA, USA; VA Northern California Health Care System, Mather, CA, USA
| | - Stella Ahdoot
- University of California, Davis, CA, USA; VA Northern California Health Care System, Mather, CA, USA
| | - Narin Sriratanaviriyakul
- University of California, Davis, CA, USA; VA Northern California Health Care System, Mather, CA, USA
| | | | - Nicholas Stollenwerk
- University of California, Davis, CA, USA; VA Northern California Health Care System, Mather, CA, USA
| | - Michael Schivo
- University of California, Davis, CA, USA; VA Northern California Health Care System, Mather, CA, USA
| | - Richart Harper
- University of California, Davis, CA, USA; VA Northern California Health Care System, Mather, CA, USA
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13
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Alici IO, Yekeler E, Yazicioglu A, Turan S, Tezer-Tekce Y, Demirag F, Karaoglanoglu N. A case of acute fibrinous and organizing pneumonia during early postoperative period after lung transplantation. Transplant Proc 2016; 47:836-40. [PMID: 25891742 DOI: 10.1016/j.transproceed.2015.02.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 01/15/2015] [Accepted: 02/09/2015] [Indexed: 01/16/2023]
Abstract
Acute fibrinous and organizing pneumonia (AFOP) is a distinct histologic pattern usually classified under the term chronic lung allograft dysfunction. We present a 48-year-old female patient who experienced AFOP during the 2nd week of double lung transplantation for pulmonary Langerhans cell histiocytosis and secondary pulmonary hypertension. During the 8th day after transplantation, fever and neutrophilia developed together with bilateral consolidation. Infection markers were elevated. Despite coverage of a full antimicrobial spectrum, the situation progressed. The patient was diagnosed with AFOP with transbronchial biopsy. The infiltration resolved and the patient improved dramatically with the initiation of pulse corticosteroid treatment. AFOP should be suspected when there is a pulmonary consolidation after lung transplantation, even in the very early post-transplantation period. Several causes, such as alveolar damage and drug reactions, should be considered in the differential diagnosis.
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Affiliation(s)
- I O Alici
- Thoracic Surgery and Lung Transplantation Center, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
| | - E Yekeler
- Thoracic Surgery and Lung Transplantation Center, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - A Yazicioglu
- Thoracic Surgery and Lung Transplantation Center, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - S Turan
- Thoracic Surgery and Lung Transplantation Center, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Y Tezer-Tekce
- Thoracic Surgery and Lung Transplantation Center, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - F Demirag
- Department of Pathology, Ataturk Chest Diseases and Thoracic Surgery Education and Research Hospital, Ankara, Turkey
| | - N Karaoglanoglu
- Thoracic Surgery and Lung Transplantation Center, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
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14
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Kuza C, Matheos T, Kathman D, Heard SO. Life after acute fibrinous and organizing pneumonia: a case report of a patient 30 months after diagnosis and review of the literature. J Crit Care 2016; 31:255-61. [PMID: 26578116 PMCID: PMC7126573 DOI: 10.1016/j.jcrc.2015.10.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 09/17/2015] [Accepted: 10/01/2015] [Indexed: 01/03/2023]
Abstract
Acute fibrinous and organizing pneumonia (AFOP) is a rare histologic interstitial pneumonia pattern recently described in the literature with fewer than 120 cases published. AFOP is often difficult to diagnose and may be mistaken for other pulmonary disorders such as interstitial pneumonias or pneumonitides. Patients often present with vague symptoms of cough, dyspnea, hemoptysis, fatigue, and occasionally respiratory failure. Radiological findings show diffuse patchy opacities and ground glass appearance of the lungs. On histologic examination, intra-alveolar fibrin balls are observed. We discuss a case of a man who presented with hemoptysis and dyspnea and whose open lung biopsy revealed AFOP. We will describe the presentation, diagnosis, and post-discharge course, and review the current literature. There are only 4 cases which have reported the patients' course of disease after 1 year, the longest being 2 years. To our knowledge, this is the only case of AFOP in the literature that describes the course of a patient more than 2 years after the diagnosis of AFOP, and is the most comprehensive review of the current literature.
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Affiliation(s)
- Catherine Kuza
- Department of Anesthesiology and Critical Care Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA; Department of Anesthesiology, University of Massachusetts Medical School, 55 North Lake Avenue, Worcester, MA, 01655, USA.
| | - Theofilos Matheos
- Department of Anesthesiology, University of Massachusetts Medical School, 55 North Lake Avenue, Worcester, MA, 01655, USA
| | - Deirdre Kathman
- Department of Medicine (Pulmonary/Critical Care Medicine), University of Massachusetts Medical School, 55 North Lake Avenue, Worcester, MA, 01655, USA
| | - Stephen O Heard
- Department of Anesthesiology, University of Massachusetts Medical School, 55 North Lake Avenue, Worcester, MA, 01655, USA
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15
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Yamamoto M, Murata K, Kiriu T, Kouzai Y, Takamori M. Acute Fibrinous and Organizing Pneumonia with Myelodysplastic Syndrome: Corticosteroid Monotherapy Led to Successful Ventilator Weaning. Intern Med 2016; 55:3155-3159. [PMID: 27803411 PMCID: PMC5140866 DOI: 10.2169/internalmedicine.55.6864] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
A 62-year-old man with myelodysplastic syndrome (MDS) presented to our hospital with a high fever. Although treatment with broad-spectrum antibiotics was initiated, his respiratory status worsened to the point that he required mechanical ventilation. However, he was successfully treated with a corticosteroid without immunosuppression. Sequential transbronchial lung biopsies revealed abundant fibrin exudate in the alveolar spaces, which was subsequently replaced by fibroblasts, showing that acute fibrinous and organizing pneumonia (AFOP) gradually changes into organizing pneumonia. Our case demonstrated both the efficacy of corticosteroid-monotherapy and the histological course of AFOP.
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Kokosi MA, Nicholson AG, Hansell DM, Wells AU. Rare idiopathic interstitial pneumonias: LIP and PPFE and rare histologic patterns of interstitial pneumonias: AFOP and BPIP. Respirology 2015; 21:600-14. [DOI: 10.1111/resp.12693] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 09/22/2015] [Accepted: 10/24/2015] [Indexed: 12/29/2022]
Affiliation(s)
- Maria A. Kokosi
- Interstitial Lung Disease Unit; Royal Brompton Hospital, Royal Brompton and Harefield NHS Foundation Trust; London UK
| | - Andrew G. Nicholson
- Department of Histopathology; Royal Brompton Hospital, Royal Brompton and Harefield NHS Foundation Trust; London UK
- National Heart and Lung Institute; Imperial College; London UK
| | - David M. Hansell
- Department of Radiology; Royal Brompton Hospital, Royal Brompton and Harefield NHS Foundation Trust; London UK
- National Heart and Lung Institute; Imperial College; London UK
| | - Athol U. Wells
- Interstitial Lung Disease Unit; Royal Brompton Hospital, Royal Brompton and Harefield NHS Foundation Trust; London UK
- National Heart and Lung Institute; Imperial College; London UK
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17
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Chen Y, Zhou X, Rong L. Analysis of mechanical ventilation and lipopolysaccharide‑induced acute lung injury using DNA microarray analysis. Mol Med Rep 2015; 11:4239-45. [PMID: 25672411 PMCID: PMC4394949 DOI: 10.3892/mmr.2015.3335] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 01/15/2015] [Indexed: 01/25/2023] Open
Abstract
Gene expression profiles of samples taken from patients with acute lung injury (ALI) induced by mechanical ventilation (MV) and lipopolysaccharide (LPS) were analyzed in order to identify key genes, and explore the underlying mechanisms. The GSE2411 microarray data set was downloaded from the Gene Expression Omnibus. This data set contained microarray data from 24 mouse lung samples, which were equally divided into four groups: Control group, MV group, LPS group and MV+LPS group. Differentially expressed genes (DEGs) were identified in the MV, LPS and MV+LPS groups, as compared with the control group, using packages of R software. Hierarchical clustering and between‑group comparisons were performed for each group of DEGs. Overrepresented biological processes were revealed by functional enrichment analysis using the Database for Annotation, Visualization and Integrated Discovery. Unique DEGs in the LPS and MV+LPS groups were selected, and pathway enrichment analyses were performed using the Kyoto Encyclopedia of Genes and Genomes Orthology Based Annotation system. A total of 32, 264 and 685 DEGs were identified in the MV, LPS and MV+LPS groups, respectively. The MV+LPS group had more DEGs, as compared with the other two treatment groups. Genes associated with the immune and inflammatory responses were significantly overrepresented in both the LPS and MV+LPS groups, suggesting that LPS dominated the progression of ALI. Unique DEGs in the LPS and MV+LPS groups were associated with cytokine‑cytokine receptor interaction. The Janus kinase‑signal transducer and activator of transcription signaling pathway was shown to be enriched in the LPS+MV‑unique DEGs. The results of the present study demonstrated that MV could exaggerate the transcriptional response of the lungs to LPS. Numerous key genes were identified, which may advance knowledge regarding the pathogenesis of ALI.
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Affiliation(s)
- Yuqing Chen
- Department of Respiratory Medicine, Shanghai First People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, P.R. China
| | - Xin Zhou
- Department of Respiratory Medicine, Shanghai First People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, P.R. China
| | - Ling Rong
- Department of Respiratory Medicine, The People's Hospital of Bozhou, Bozhou, Anhui 236804, P.R. China
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18
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Akhtar A, Ul Abideen Z. Acute fibrinous and organizing pneumonia masquerading as a lower respiratory tract infection: a case report and review of the literature. BMC Res Notes 2015; 8:38. [PMID: 25890084 PMCID: PMC4331172 DOI: 10.1186/s13104-015-0984-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 01/15/2015] [Indexed: 01/16/2023] Open
Abstract
Background Acute Fibrinous and Organizing Pneumonia is a rare entity characterized by the histological pattern suggestive of diffuse alveolar damage, eosinophilic pneumonia and organizing pneumonia; the presence of intra alveolar “fibrin balls” distinguishes it from these conditions. Herein, we describe the association of acute fibrinous and organizing pneumonia with a respiratory tract infection. We believe that such an association has been extremely rarely described. Case presentation We report the case of a 68 year old female patient of Afghan descent who presented with shortness of breath, cough and high grade fever not responding satisfactorily to standard antibiotic therapy. Imaging revealed bilateral basilar infiltrates and ground glass opacification of the right lower lung zone. Though the inflammatory markers decreased with antibiotic therapy, there was minimal improvement in the patient’s symptoms and radiological appearance of the lungs. Bronchoscopy was refused by the patient’s family and a Computed Tomography guided biopsy of the lung revealed a histological diagnosis of acute fibrinous and organizing pneumonia. Patient was initiated on high dose intravenous corticosteroid therapy followed by a maintenance dose of prednisolone at 40 mg/day. She recovered dramatically. However, due to poor compliance with treatment, she relapsed and was re-treated with the same regimen. Currently she is completely symptom free and is on a tapering corticosteroid dose. Conclusion We conclude that AFOP may be a rare but under diagnosed entity and recommend that it should be considered in the differentials of a suspected pulmonary infection unresponsive to optimum antibiotic therapy.
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Affiliation(s)
- Aftab Akhtar
- Department of Pulmonology and Critical Care, Shifa International Hospital, Islamabad, Pakistan.
| | - Zain Ul Abideen
- Resident Internal Medicine, Department of Internal Medicine, Shifa International Hospital, Islamabad, Pakistan.
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Hara Y, Shinkai M, Kanoh S, Kawana A, Rubin BK, Matsubara O, Kaneko T. Clinico-pathological analysis referring hemeoxygenase-1 in acute fibrinous and organizing pneumonia patients. Respir Med Case Rep 2015; 14:53-6. [PMID: 26029580 PMCID: PMC4356040 DOI: 10.1016/j.rmcr.2015.01.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Acute fibrinous and organizing pneumonia (AFOP) is a very rare pathological entity of lung injury characterized by intra-alveolar fibrin balls. Hemeoxygenase (HO) -1 is a cytoprotective enzyme against oxidative stress and inflammation. It is known to be expressed in the alveolar macrophages in the healthy adults and overexpressed in other various lung cells of the lung injury patients. We experienced two cases of subacute form AFOP for these 10 years and reviewed clinico-pathological characteristics. The average age was 62 years old and both were male. The etiology of both cases was idiopathic. The average PaO2/FIO2 ratio was 274.5 ± 84.1. The average levels of C-reactive protein and surfactant protein - A of the serum were elevated to 19.8 ± 6.3 mg/dL and 67.6 ± 15.8 ng/mL, respectively. Serum sialylated carbohydrate antigen levels were normal in both cases. The characteristic radiographic findings were bilateral consolidations and ground glass opacities. Lung biopsy specimens revealed fibrin balls and alveolitis with abundant cellular HO-1 expression. Steroid response was excellent and the pulmonary involvements absolutely disappeared for about 3 months.
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Affiliation(s)
- Yu Hara
- Division of Infectious Diseases and Pulmonary Medicine, Department of Internal Medicine, National Defense Medical College, Saitama, Japan ; Respiratory Disease Center, Yokohama City University Medical Center, Kanagawa, Japan
| | - Masaharu Shinkai
- Division of Infectious Diseases and Pulmonary Medicine, Department of Internal Medicine, National Defense Medical College, Saitama, Japan ; Respiratory Disease Center, Yokohama City University Medical Center, Kanagawa, Japan
| | - Soichiro Kanoh
- Division of Infectious Diseases and Pulmonary Medicine, Department of Internal Medicine, National Defense Medical College, Saitama, Japan
| | - Akihiko Kawana
- Division of Infectious Diseases and Pulmonary Medicine, Department of Internal Medicine, National Defense Medical College, Saitama, Japan
| | - Bruce K Rubin
- Department of Pediatrics, Virginia Commonwealth University, Richmond, USA
| | - Osamu Matsubara
- Departments of Basic Pathology, National Defense Medical College, Saitama, Japan
| | - Takeshi Kaneko
- Respiratory Disease Center, Yokohama City University Medical Center, Kanagawa, Japan
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Renaud-Picard B, Dégot T, Biondini D, Weingertner N, Reeb J, Chenard M, Kessler R. Successful Lung Retransplantation in a Patient With Acute Fibrinous and Organizing Pneumonia: A Case Report. Transplant Proc 2015; 47:182-5. [DOI: 10.1016/j.transproceed.2014.08.039] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 08/19/2014] [Indexed: 11/16/2022]
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Lococo F, Rossi G, Filice A, Prandini N, Rapicetta C, Paci M. A woman with progressive dyspnea and multiple lung consolidative lesions. Am J Respir Crit Care Med 2014; 190:e22-3. [PMID: 25221891 DOI: 10.1164/rccm.201310-1759im] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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23
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Paraskeva M, McLean C, Ellis S, Bailey M, Williams T, Levvey B, Snell GI, Westall GP. Acute Fibrinoid Organizing Pneumonia after Lung Transplantation. Am J Respir Crit Care Med 2013; 187:1360-8. [DOI: 10.1164/rccm.201210-1831oc] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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