ABSTRACT
AA amyloidosis is one of the most significant complications of rheumatoid arthritis characterized by the deposition of amyloid A (AA) in multiple organs and tissues in the body. This disorder displays variable clinical symptoms depending upon the involved organ and a diagnosis is rendered through a biopsy of the affected organ, followed by staining using Congo-red which reveals an apple-green birefringence. Fundamental disease control is critical in the treatment of AA amyloidosis. Anti-tumor necrosis factor alpha (anti TNF-alpha) agents are promising in inducing clinical remission by suppressing systemic inflammation in AA amyloidosis. We report a case of AA amyloidosis in a 71 year old woman with rheumatoid arthritis that responded well to infliximab therapy.
Subject(s)
Female , Humans , Amyloid , Amyloidosis , Antibodies, Monoclonal , Arthritis, Rheumatoid , Biopsy , Birefringence , Inflammation , Necrosis , InfliximabABSTRACT
Acute fibrinous and organizing pneumonia (AFOP) is a histological pattern consisting of intra-alveolar fibrin in the form of fibrin "balls" and organizing pneumonia, without hyaline membranes or prominent eosinophil infiltration. Some reports suggest that the clinical course and pathological findings of AFOP are different from typical findings of bronchiolitis obliterans organizing pneumonia (BOOP) or eosinophilic pneumonia (EP), and its prognosis can be better or similar to that of diffuse alveolar damage (DAD). We report two cases of pathologically demonstrated AFOP experienced recently at our institute. One fatal case revealed a rapid development of respiratory failure and the need for mechanical ventilation. Another nonfatal case revealed subacute diffuse bilateral lung infiltration without the need for mechanical ventilation. Judging from our experience, the patient who required a mechanical ventilator had a poorer prognosis than the one who did not need a mechanical ventilator.
Subject(s)
Humans , Cryptogenic Organizing Pneumonia , Eosinophils , Fibrin , Hyalin , Lung , Membranes , Pneumonia , Prognosis , Pulmonary Eosinophilia , Respiration, Artificial , Respiratory Insufficiency , Ventilators, MechanicalABSTRACT
Acute fibrinous and organizing pneumonia (AFOP) is a histological pattern consisting of intra-alveolar fibrin in the form of fibrin "balls" and organizing pneumonia, without hyaline membranes or prominent eosinophil infiltration. Some reports suggest that the clinical course and pathological findings of AFOP are different from typical findings of bronchiolitis obliterans organizing pneumonia (BOOP) or eosinophilic pneumonia (EP), and its prognosis can be better or similar to that of diffuse alveolar damage (DAD). We report two cases of pathologically demonstrated AFOP experienced recently at our institute. One fatal case revealed a rapid development of respiratory failure and the need for mechanical ventilation. Another nonfatal case revealed subacute diffuse bilateral lung infiltration without the need for mechanical ventilation. Judging from our experience, the patient who required a mechanical ventilator had a poorer prognosis than the one who did not need a mechanical ventilator.