Is Acute Fibrinous and Organizing Pneumonia the Expression of Immune Dysregulation?

Labarinas, Sonia; Gumy‐Pause, Fabienne; Rougemont, Anne‐Laure; Baerlocher, Gabriela M.; Leibundgut, Elisabeth Oppliger; Porret, Naomi; Schäppi, Michela; Barazzone-Argiroffo, Constance; Passweg, Jakob; Merlini, Laura; Özşahin, Hülya; Ansari, Marc

doi:10.1097/mph.0b013e31827e5782

Cited by 13 publications

(10 citation statements)

References 22 publications

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“…There was no response to treatment with antithymocyte globulin or cyclosporine. Disease resolution occurred after hematopoietic stem cell transplant [30]. Renaud-Picard et al described a patient with cystic fibrosis who received a lung transplant.…”

Section: Discussionmentioning

confidence: 99%

Life after acute fibrinous and organizing pneumonia: a case report of a patient 30 months after diagnosis and review of the literature

Kuza

Matheos

Kathman

et al. 2016

Journal of Critical Care

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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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Section: Discussionmentioning

confidence: 99%

Life after acute fibrinous and organizing pneumonia: a case report of a patient 30 months after diagnosis and review of the literature

Kuza

Matheos

Kathman

et al. 2016

Journal of Critical Care

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“…[ 1 2 ] So far, a total of 21 English articles introduced us with this newly discovered disease, and 67 patients with AFOP were reported or mentioned in their articles. [ 3 4 5 6 7 8 ] Most of the literatures were case reports and there was no further systematic information regarding clinical parameters related to this rare and unique pathological entity.…”

Section: Introductionmentioning

confidence: 99%

Clinical and Radiological Profile of Acute Fibrinous and Organizing Pneumonia

Dai

Shen

et al. 2015

Chinese Medical Journal

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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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“…Transbronchial biopsy as in our case has also been rarely used so far. [ 1 3 6 7 8 9 10 11 12 13 ] Diagnosis of AFOP in Indian case reports has been achieved through CT guided biopsy followed by treatment of the disease by prednisolone. [ 12 ]…”

Section: Discussionmentioning

confidence: 99%

Acute fibrinous and organizing pneumonia: A rare form of nonbacterial pneumonia

Saxena¹,

Kumar²,

Mittal³

et al. 2016

Indian Journal of Critical Care Medicine

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Acute fibrinous and organizing pneumonia (AFOP) is a rare disease characterized by bilateral basilar infiltrates and histological findings of organizing pneumonia and intra-alveolar fibrin in the form of “fibrin balls.” Here, we report a 43-year-old female with complaints of fever, dry cough, and shortness of breath with hypoxemia. High-resolution computed tomography thorax revealed diffuse confluent consolidation in bilateral lung zones. Bronchoscopy and transbronchial biopsy revealed features of AFOP. With prednisolone treatment, there was an improvement in her condition. AFOP is a rare disease and should be taken into consideration and differential diagnosis of severe acute pneumonias with no significant comorbidities.

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Is Acute Fibrinous and Organizing Pneumonia the Expression of Immune Dysregulation?

Cited by 13 publications

References 22 publications

Life after acute fibrinous and organizing pneumonia: a case report of a patient 30 months after diagnosis and review of the literature

Life after acute fibrinous and organizing pneumonia: a case report of a patient 30 months after diagnosis and review of the literature

Clinical and Radiological Profile of Acute Fibrinous and Organizing Pneumonia

Acute fibrinous and organizing pneumonia: A rare form of nonbacterial pneumonia

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