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

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.

A case report of acute fibrinous and organizing pneumonia with pneumothorax and avian exposure history

“…Unilateral or bilateral pleural effusions can also appear (13,14). Our patient presented with fever and productive cough, and then developed pneumothorax, which had not previously been reported for patients with AFOP.…”

“…1,15 Unilateral or bilateral pleural effusions can also appear. 13,14 Our patient presented with fever and productive cough, and then developed pneumothorax, which had not previously been reported for patients with AFOP. This suggests that patients with AFOP can present with a wide variety of respiratory signs and symptoms.…”

“…Kusa et al summarized 111 cases reported in the literature. 13 They found that glucocorticoids were the most common and successful treatment modality. There was no consensus on the dosage of corticosteroids.…”

Acute fibrinous and organizing pneumonia in a patient with Sjogren’s syndrome

“…AFOP is a relatively new entity with less than 115 cases reported in the literature up till 2015 [6]. AFOP have been associated with rheumatologic disease, infections, drug reaction, environmental exposures, autoimmune disease and lung transplantation [1], [6].…”

“…AFOP have been associated with rheumatologic disease, infections, drug reaction, environmental exposures, autoimmune disease and lung transplantation [1], [6].…”