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Abstract
Case Report
A case of acute fibrinous and organizing pneumonia with recurrent exacerbations
Norihiko Nakanishia Yuji Ohtsukib Kazuhiko Saekia Junya Nakamuraa Masaaki Shiojiria Haruka Kondoha
aDepartment of Respirology, Ehime Prefectural Central Hospital
bDepartment of Diagnostic Pathology, Matsuyama Shimin Hospital
ABSTRACT
Organizing pneumonia (OP) is recognized as a disease entity with a good prognosis. Recently, a new disease entity — acute fibrinous and organizing pneumonia (AFOP) — has been identified which has a poor prognosis.
We report a case of AFOP with recurrent exacerbations after steroid tapering. A 43-year-old man developed cough, fever, and exertional dyspnea. Chest X-ray and high-resolution computed tomography showed patchy, bilateral infiltrative shadows on the lung fields. Transbronchial lung biopsy specimens revealed OP with intraluminal organization and fibrin deposits. We considered that the patient had AFOP, and steroid therapy was started. Abnormal chest shadows disappeared; however, new infiltrates appeared after steroid tapering. Additional cyclosporine A was effective. AFOP should be recognized as an OP in which long-term therapy is effective.
KEYWORDS
Organizing pneumonia (OP) Acute fibrinous and organizing pneumonia (AFOP) Recurrent exacerbations Steroid therapy
Received 25 Aug 2017 ／ Accepted 7 May 2018
AJRS, 7(4): 245-249, 2018
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