Acute fibrinous and organising pneumonia

Abstract

Acute fibrinous and organising pneumonia (AFOP) is a rare histological pattern of interstitial lung disease. The authors describe a 60-year-old woman admitted to the hospital for sustained fever, presenting with an alveolar opacity on chest X-ray, with the presumed diagnosis of community-acquired pneumonia and the onset of antibiotics. Since serological results suggested that was the infectious agent, she was discharged on levofloxacin. A week later, she was again admitted with fever. CT scan showed opacities with crescentic morphology and a central ground-glass area suggestive of cryptogenic organising pneumonia. Microbiological, serological and autoimmunity tests were negative. She underwent surgical lung biopsy that revealed inflammatory infiltrate, macrophage desquamation, fibroblasts proliferation and fibrin deposition in the alveolar spaces, consistent with AFOP. She started corticotherapy with good response. Disease relapsed after prednisolone discontinuation, 10 months later. Currently, the patient is on prednisolone 5 mg/day without clinical and radiological recurrence.

Systematic Review of Systemic Corticosteroids for Treatment of Organizing Pneumonia

“…Then 122 articles were selected for reading. 2 , 4 , 5 , 6 , 7 , 8 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 ,…”

Cryptogenic Acute Fibrinous and Organizing Pneumonia: A Case Report

“…Corticosteroids remain the mainstay of treatment for AFOP, with positive outcomes reported in multiple case reports [7,[9][10][11]. As there is currently no consensus on dose and treatment duration, these should be guided by the therapeutic response, both clinically and radiologically.…”

Legionella: Organizing Pneumonia vs Persistent Infection

“…Interstitial lung disease describes a wide spectrum of restrictive lung injury, with different subtypes often identified by histology. Organizing pneumonia is an acute form of interstitial lung disease describing irregular deposition of fibrin within alveoli [ 1 , 2 ]. This development of patchy lung fibrosis is rare and can develop following an insult to the alveoli, including various types of pathogen-associated pneumonia, connective tissue diseases, and medications.…”

“…This development of patchy lung fibrosis is rare and can develop following an insult to the alveoli, including various types of pathogen-associated pneumonia, connective tissue diseases, and medications. Treatment involves systemic steroids, which can result in rapid symptom and radiographic improvement [ 2 ]. Here we describe an interesting case of organizing pneumonia that developed in a patient who had previously undergone a prolonged hospitalization for Legionella pneumonia.…”