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1.
Rev. Assoc. Med. Bras. (1992, Impr.) ; 69(2): 267-271, Feb. 2023. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1422616

ABSTRACT

SUMMARY BACKGROUND AND AIM: Meteorological factors affect the respiratory system, and the most important factor is the change in ambient temperature and humidity. We aimed to investigate the seasonal characteristics of patients diagnosed with cryptogenic organizing pneumonia. METHODS: The study included 84 cryptogenic organizing pneumonia, 55 chronic obstructive pulmonary disease, and 42 asthma patients. To determine the characteristics of the disease according to the seasons, the number of attacks and admissions was grouped according to the seasonal characteristics and analyzed for three groups. RESULTS: Among cryptogenic organizing pneumonia and chronic obstructive pulmonary disease patients, males significantly predominated (p<0.001). The hospitalization rate was highest in chronic obstructive pulmonary disease patients but similar to cryptogenic organizing pneumonia and asthma patients (p<0.001). The highest admission rate in cryptogenic organizing pneumonia patients was observed in spring (39.3% in spring, 26.2% in fall, 22.6% in winter, and 11.9% in summer). In winter, cryptogenic organizing pneumonia patients were admitted less frequently than chronic obstructive pulmonary disease and asthma patients. The neutrophil-to-lymphocyte ratio was higher in cryptogenic organizing pneumonia patients than in asthma patients and similar to chronic obstructive pulmonary disease patients. CONCLUSION: As a result of our study, the high rate of diagnosis and admission in the spring in cryptogenic organizing pneumonia suggested that the effect of allergens on the formation of cryptogenic organizing pneumonia should be investigated. In contrast, it should be kept in mind that cryptogenic organizing pneumonia may develop as a prolonged finding of involvement that may occur in the lung parenchyma due to lung infections and/or cold weather triggering during the winter months. In this regard, further studies can be conducted in which allergens and/or the history of infection in patients and meteorological variables are also evaluated.

2.
Journal of Central South University(Medical Sciences) ; (12): 935-940, 2023.
Article in English | WPRIM | ID: wpr-982366

ABSTRACT

Cryptogenic organic pneumonia (COP) refers to organic pneumonia that has not been identified a clear cause by current medical methods. A small proportion of COP can exhibit severe and progressive characteristics, while severe COP can cause systemic inflammatory storms and can be secondary to hemophilia. This article reported a case of acute severe COP secondary to hemophilia. A 67-year-old male patient was admitted to the hospital due to cough, shortness of breath, and fever. At first, he was misdiagnosed as severe pneumonia, but failed to receive anti infection treatments. Sputum pathogenetic examination and Macrogene testing of alveolar lavage fluid were performed, and no etiology was found to explain the patient's condition. The condition was gradually worsened and hemophilia occurred to explain, suggesting that acute severe COP was relevant. After receiving hormone treatment, the condition gradually relieved and the absorption of lung lesions improved. Hemophilia secondary to COP is rare, and the specific mechanism needs further study.


Subject(s)
Male , Humans , Aged , Hemophilia A/complications , Pneumonia/diagnosis , Bronchoalveolar Lavage Fluid , Cough , Dyspnea/etiology
3.
Chinese Medical Sciences Journal ; (4): 66-69, 2023.
Article in English | WPRIM | ID: wpr-981586

ABSTRACT

Both anti-glomerular basement membrane (GBM) disease and the anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) are common causes of pulmonary-renal syndrome. Organizing pneumonia (OP), a special pattern of interstitial lung disease, is extremely rare either in AAV or anti-GBM disease. We report an old woman presented with OP on a background of co-presentation with both ANCA and anti-GBM antibodies.


Subject(s)
Female , Humans , Antibodies, Antineutrophil Cytoplasmic , Organizing Pneumonia , Autoantibodies , Glomerulonephritis , Anti-Glomerular Basement Membrane Disease , Pneumonia , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/complications
4.
Rev. chil. enferm. respir ; 39(2): 169-174, 2023. ilus
Article in Spanish | LILACS | ID: biblio-1515116

ABSTRACT

La neumonía organizada es una entidad poco frecuente, caracterizada por la formación de conglomerados fibroblásticos intraalveolares conocidos como cuerpos de Masson, que puede ser criptogénica o secundaria a una respuesta inmunitaria a diversos estímulos, tales como enfermedades hematológicas, autoinmunitarias, exposición a sustancias químicas, fármacos, tóxicos, etc. Detectada y tratada de forma precoz, suele tener una buena respuesta a la corticoterapia, aunque si se diagnostica de forma tardía, la afectación pulmonar puede ser extensa, y, además, si el estímulo antigénico persiste, la respuesta al tratamiento será incompleta. Presentamos el caso clínico de una paciente de 65 años de edad quien hace 18 meses aproximadamente presentó la rotura intracapsular de sus implantes mamarios, 27 años después de su colocación. Con el mismo tiempo de evolución ha desarrollado progresivamente disnea, tos seca y dolor inframamario, habiendo llegado al diagnóstico de neumonía organizada bilateral difusa, asociada a dicha rotura de implantes.


Organizing pneumonia is a rare entity, characterized by the formation of intraalveolar fibroblastic conglomerates known as Masson bodies, which may be cryptogenic or secondary to an immune response to various stimuli, such as hematological, autoimmune diseases, exposure to chemical substances, drugs, toxics, etc. If it is detected and treated early, it usually has a good response to corticosteroid therapy, although if it is diagnosed late, the lung involvement can be extensive, and furthermore, if the antigenic stimulus persists, the response to treatment will be incomplete. We present the clinical case of a 65-year-old patient who had intracapsular rupture of her breast implants approximately 18 months ago, 27 years after their placement. With the same evolution time, she progressively developed dyspnea, dry cough and under mammary pain, having reached the diagnosis of diffuse bilateral organizing pneumonia, associated with implant rupture.


Subject(s)
Humans , Female , Aged , Prosthesis Failure , Breast Implants/adverse effects , Organizing Pneumonia/etiology , Rupture , Silicones , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Organizing Pneumonia/therapy , Organizing Pneumonia/diagnostic imaging
5.
Rev. colomb. reumatol ; 29(4)oct.-dic. 2022.
Article in English | LILACS | ID: biblio-1536214

ABSTRACT

Introduction: Organizing pneumonia is a rare clinico-pathological syndrome. This crypto-genic or secondary condition is of unknown origin, and may be infectious, or associated with autoimmune diseases, cancer, drugs, or radiation. Case description: The case is presented of a 52-year-old patient who was diagnosed with organizing pneumonia secondary to anti-synthetase syndrome. Discussion: It is intended to make known that not all pulmonary consolidative clinical pictures correspond to infectious processes. In this case, an organizing pneumonia secondary to anti-synthetase syndrome is documented. Despite being a disorder that is classified as an idiopathic inflammatory myopathy, it manifests as an interstitial lung disease with predominantly respiratory symptoms.


Introducción: La neumonía organizativa es un síndrome clínico-patológico poco frecuente, dentro del cual se desconoce la etiología de la denominada neumonía criptogénica o secundaria, que puede ser infecciosa o asociada con enfermedades autoinmunes, cáncer, fármacos o radiación. Descripción del caso: Se presenta el caso de una paciente de 52 arios a quien se le diagnostica neumonía organizativa secundaria a síndrome antisintetasa. Discusión: Se busca dar a conocer que no todos los cuadros clínicos de consolidación pulmonar corresponden a procesos infecciosos. En este caso se documentó una neumonía organizativa secundaria a síndrome antisintetasa, la cual a pesar de ser una patología que se cataloga como una miopatía inflamatoria idiopática, se manifestó como una enfermedad pulmonar intersticial con síntomas predominantemente respiratorios.


Subject(s)
Humans , Middle Aged , Respiratory Tract Diseases , Bronchial Diseases , Cryptogenic Organizing Pneumonia
6.
Rev. argent. radiol ; 86(1): 58-63, Apr. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1376430

ABSTRACT

Resumen La neumonía en organización es un tipo de enfermedad pulmonar intersticial difusa que puede ser idiopática (criptogénica) o secundaria a numerosas etiologías, y se asocia con hallazgos clínicos y de laboratorio inespecíficos. Su diagnóstico y tratamiento exigen un equipo interdisciplinario, en el que las imágenes desempeñan un papel indispensable. Se presenta una serie de nueve casos, haciendo énfasis en las características clínicas y profundizando en los diversos patrones imagenológicos identificados. También se aporta una revisión de las variantes recientemente descritas.


Abstract Organizing pneumonia is a type of diffuse interstitial lung disease that can be idiopathic (cryptogenic) or secondary to numerous etiologies, and is an entity associated with nonspecific clinical and laboratory findings. Its diagnosis and treatment require an interdisciplinary team in which images play an indispensable role. The presentation of a series of nine cases is made, emphasizing the clinical characteristics and delving into the various identified imaging patterns. A review of the recently described variants is also provided.

7.
Rev. am. med. respir ; 21(4): 348-353, dic. 2021. graf
Article in English | LILACS, BINACIS | ID: biblio-1431459

ABSTRACT

Abstract COVID-19 pneumonia generates both immediate damage due to the viral effects and distant damage due to inflammatory immune deregulation. Systemic corticosteroid therapy has proven to be beneficial in the first part of the process, but its usefulness in post-acute damage is still unclear. The number of affected patients makes it imperative to find a treatment that reduces potential pulmonary sequelae. This series of cases included 18 patients admitted to polyvalent private medical institutions of Buenos Aires City: 15 were male and 3 were female; age 58.4 ± 13.6 years. History of most common comorbidities: AHT (4 patients), obesity (6 patients) and smoking (4 patients). Five patients had no medical history. All patients showed dyspnea, oxygen desaturation, and persistent or progressive tomo graphic abnormalities 14 days after their infection. All of them received dexamethasone according to current regulations. Subsequently, given the poor evolution, they were administered oral and/or intravenous corticosteroids with the same treatment used for secondary organizing pneumonia (OP). A transbronchial biopsy was performed in 6 of the patients, showing an OP pattern in 3 of them. Four weeks after the beginning of the treatment, all of the patients showed clinical improvement expressed by decreased dyspnea and the fact that they didn't require oxygen anymore and that all chest tomographies showed clearly reduced pulmonary parenchymal involve ment. Systemic corticosteroids administered in the post-acute period of COVID-19 have a clinical and radiological beneficial effect.


Subject(s)
Pneumonia , Adrenal Cortex Hormones , COVID-19 , Organizing Pneumonia
8.
Braz. j. infect. dis ; 25(1): 101541, jan., 2021. tab, graf
Article in English | LILACS | ID: biblio-1249297

ABSTRACT

ABSTRACT Organizing pneumonia emerges as a late phase complication of COVID-19. Corticosteroids are standard therapy for organizing pneumonia, but the question of whether an approach with high dose corticosteroids would be beneficial for patients with organizing pneumonia secondary to COVID-19 remains to be answered.Herein we report a series of three patients, one male and two females, mean age 58.3 years old, admitted for COVID-19 with severe pulmonary disease requiring ventilatory support. The patients underwent chest computed tomography scans due to maintained hypoxemia, which showed a pattern compatible with organizing pneumonia. The patients were treated with a high dose of corticosteroids (prednisone 1 mg/kg PO), showing marked clinical improvement, and decreasing oxygen flow ratio demand. They were discharged after a mean period of 6.3 days of hospitalization.Our report suggests that patients with COVID-19 with organizing pneumonia might benefit from high dose corticosteroids as an adjuvant therapy.


Subject(s)
Pneumonia/drug therapy , COVID-19 , Adrenal Cortex Hormones/adverse effects , SARS-CoV-2 , Lung , Middle Aged
9.
Clinical Medicine of China ; (12): 395-399, 2021.
Article in Chinese | WPRIM | ID: wpr-909765

ABSTRACT

Organizing pneumonia (OP) is a common lung interstitial disease.On chest CT, the main imaging manifestations of OP are consolidation and/or nodules with air bronchogram and traction bronchiectasis, predominantly peribronchovascular and subpleural regions." Reverse halo" sign, band-like consolidation and paralobular consolidation are also can be seen.Migratory behavior of lesions may be evident in follow up studies.The diagnosis of OP is a comprehensive analysis based on imaging combined with clinical and pathological findings.

10.
Clinical Medicine of China ; (12): 391-394, 2021.
Article in Chinese | WPRIM | ID: wpr-909764

ABSTRACT

Organizing pneumonia (OP), as a special response of the lung to the tissue damage, is pathologically defined as the presence of granulation tissue in the distal airways (bronchioles, alveolar ducts, and alveoli). The organic nodule is composed of fibroblasts and mucopolysaccharide-rich matrix.The boundary is clear and smooth.They extend in the airway like polypoid plugs with a smooth border.They are easy to be recognized under the microscope, so the pathological diagnosis of OP is not difficult.The difficulty is to explore the hidden causes.In this process, the first step is to distinguish cryptogenic organizing pneumonia (COP) from secondary OP.The diagnosis of COP must be based on strict criteria and sufficient multidisciplinary discussion.The investigation of the cause of secondary OP is a very challenging task.Pathologists need to carefully observe the characteristics of various pathological changes associated with OP, then analyze all of the features logistically.On this basis, discuss with the clinician and finally, find out the cause that can make a reasonable explanation for the morphological changes.

11.
Clinical Medicine of China ; (12): 387-390, 2021.
Article in Chinese | WPRIM | ID: wpr-909763

ABSTRACT

Objective:Organizing pneumonia (OP) is a clinical syndrome manifested by granulation tissue plug in respiratory bronchioles, alveolar ducts and alveolar spaces pathologically.With advent of lung biopsy techniques, increasing pathological diagnosis of organizing pneumonia was made, most of which were confirmed secondary organizing pneumonia (SOP) either at time of diagnosis or on follow-up.The secondary etiology is related to the choice of treatment and prognosis.First of all, we need to rule out infection, find evidence of connective tissue disease, or previous medication, radiotherapy and even transplantation.The coexistence of multiple pathological features and simultaneous involvement of pulmonary vessels and pleura suggest possible secondary causes.The pathological diagnosis of organic pneumonia by empty core needle puncture or transbronchial lung biopsy needs to be combined with imaging to avoid omitting the tumor, granuloma and necrosis around organic pneumonia.In general, organizing pneumonia, no matter cryptogenic or secondary, is mostly responsive to corticosteroids compared with other interstitial lung diseases, although relapses are frequent.In summary, real cryptogenic organized pneumonia is actually relatively uncommon and should be diagnosed with caution.Long term follow up is not only crucial to assess the evolution of lung disease but also for looking into the underlying etiologies behind an organizing pneumonia.

12.
Malaysian Journal of Medicine and Health Sciences ; : 311-313, 2021.
Article in English | WPRIM | ID: wpr-978742

ABSTRACT

@#Pulmonary TB may present insidiously and ambiguously, leaving clinicians with a diagnostic dilemma. A 30-year-old lady with underlying spinocerebellar ataxia presented with progressive shortness of breath, prolonged cough with whitish sputum, loss of appetite and weight loss of 1-year duration. Physical examination showed a cachectic, tachypnoeic female with finger clubbing and coarse crepitations on lung auscultation. Chest radiograph showed bilateral air space opacities relatively sparing the upper zone. Contrast-enhanced CT thorax revealed bilateral cavitary necrotising consolidations, multiple scattered lung nodules with surrounding ground-glass opacities. After exclusion of alternative diagnoses, cryptogenic organizing pneumonia diagnosis was made. She had a rapid clinic improvement once steroid was started. TB polymerase chain reaction (PCR) from bronchoscopic bronchial washing eventually was positive. Anti-TB treatment was started, and oral steroid was slowly tapered down. Organizing pneumonia (OP) may complicate pulmonary TB. Diagnosing OP without lung biopsy requires a multi-disciplinary approach, taking into consideration all available evidences. Early steroid therapy is lifesaving and should be considered after thorough exclusion of alternative diseases.

13.
Rev. am. med. respir ; 20(3): 282-284, sept. 2020. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1123115

ABSTRACT

El síndrome antisintetasa es una miopatía inflamatoria autoinmune que puede presentar afectación pulmonar intersticial. La presencia de anticuerpos antisintetasa se relaciona con una mayor incidencia de enfermedad pulmonar intersticial. El patrón imagenológico y anatomopatológico de la EPID es variable, fundamentalmente inflamatorio. En el caso presentado se describe una paciente con miopatía inflamatoria y compromiso pulmonar presentando un patrón tomográfico de neumonía organizativa. Se destaca la importancia de elevar el índice de sospecha de síndrome antisintetasa ante un paciente con compromiso pulmonar y miopatía, siendo fundamental para arribar a un diagnóstico la evaluación multidisciplinaria. Se realiza una revisión de la evidencia al respecto en la discusión del caso


The antisynthetase syndrome is an autoimmune inflammatory miopathy that may show interstitial pulmonary involvement. The presence of antisynthetase antibodies is related to a higher incidence of interstitial pulmonary involvement. The imaging and anatomopathological pattern of diffuse interstitial pulmonary disease (DIPD) is variable, mainly inflammatory. This case describes a female patient with inflammatory miopathy and pulmonary involvement who shows a tomographic pattern of organizing pneumonia. It is important to increase suspicion for antisynthetase syndrome in a patient with pulmonary involvement and miopathy, where multidisciplinary evaluation is fundamental to reach a diagnosis. A review of the evidence is made in the discussion of the case.


Subject(s)
Humans , Female , Pneumonia , Ligases , Lung Diseases
14.
Rev. méd. Chile ; 147(5): 663-667, mayo 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1014276

ABSTRACT

We report a 64 years old female admitted with fever, cough, dyspnea and lung opacities in the chest X ray. A chest tomography scan (CTS) showed multiple-bilateral ring-shaped opacities and the reversed halo sign (RHS). The patient did not improve with antimicrobial therapy (AT). Infection and rheumatologic causes were excluded, therefore Cryptogenic organizing pneumonia (COP) was suspected with compatible percutaneous biopsy. Systemic steroids were started with a good clinical response. The patient was discharged four weeks after admission in good general conditions and practically no lungs opacities.


Subject(s)
Humans , Female , Middle Aged , Cryptogenic Organizing Pneumonia/pathology , Cryptogenic Organizing Pneumonia/diagnostic imaging , Biopsy , Prednisone/therapeutic use , Radiography, Thoracic , Tomography, X-Ray Computed , Cryptogenic Organizing Pneumonia/drug therapy , Glucocorticoids/therapeutic use , Lung/pathology , Lung/diagnostic imaging
15.
Chinese Journal of Ultrasonography ; (12): 688-691, 2018.
Article in Chinese | WPRIM | ID: wpr-707707

ABSTRACT

Objective To invesitigate the application of contrast enhanced ultrasound in differentiating focal organizing pneumonia( FOP) and primary lung cancer . Methods The imaging data of 23 cases with FOP ( FOP group) and 75 cases with primary lung cancer ( primary lung cancer group) on conventional ultrasound and contrast enhanced ultrasound were retrospectively analyzed . The size and arrival time( AT) of the contrast agent and the enhanced pattern of the two groups were compared . ROC curve was created to determine the most accurate AT for differential diagnosis . Results There was no significant difference in the gender and the size of nodule between the two groups ( P > 0 .05) . The age of FOP group was younger than that of primary lung cancer group ( P = 0 .013) . The AT of FOP group was much earlier than that of primary lung cancer group [ ( 6 .9 ± 2 .4) s vs ( 11 .4 ± 4 .3) s , P = 0 .000] . In FOP group ,20 patients ( 87 .0% ) showed centrifugal enhancement , 2 patients ( 8 . 7% ) showed centripetal enhancement and 1 patient ( 4 .3% ) showed diffuse homogeneous enhancement ,respectively .In primary lung cancer group , 12 patients ( 16 .0% ) showed centrifugal enhancement , 58 patients ( 77 .3% ) showed centripetal enhancement ,2 patients ( 2 .7% ) showed diffuse homogeneous enhancement and 3 patients ( 4 .0% ) showed diffuse heterogeneous enhancement ,respectively . There was significant difference in the enhanced pattern between the two groups ( P = 0 .000) . Meanwhile ,8 patients in FOP group ( 34 .8% ) and 31 patients in primary lung cancer group ( 41 .3% ) had unenhanced region in the nodule ( P = 0 .574) . ROC analysis demonstrated that AT of 8 .5 s was the best cut-off value for the differential diagnosis . When AT earlier than 8 .5 was taken as diagnostic criterion for FOP ,the diagnositc sensitivity ,specificity were 74 .7%and 82 .6% ,respectively . Conclusions Contrast-enhanced ultrasound can provide evidence in differentiating FOP from primary lung cancer .

16.
Chinese Journal of Infection and Chemotherapy ; (6): 371-375, 2017.
Article in Chinese | WPRIM | ID: wpr-615278

ABSTRACT

Objective To further improve the awareness of the clinical feature of acute fibrinous and organizing pneumonia (AFOP).Methods One case of AFOP treated in our department was described in details.The relevant cases were searched in Wanfang database using key words acute fibrinous and organizing pneumonia [in Chinese].Results Four reports containing 9 cases were identified from published literature.A total of 10 cases (including this one) were analyzed.The patients included 7 males and 3 females (43 to 78 years of age).Eight patients presented with cough.Chest tightness and dyspnea were reported in 8 cases,and fever in 9 cases.Velcro crackles were heard in 4 patients.Laboratory tests showed WBC increased in 2 cases,increased neutrophil count in 6 cases,elevated C-reactive protein in 9 cases,and faster erythrocyte sedimentation rate in 8 cases.The partial oxygen pressure (PO2) ranged from 54 mmHg to 69 mmHg.Chest CT scan showed unilateral lesions in 3 cases and bilateral lesions in 7 cases initially.The main CT findings were patchy,consolidation and ground-glass opacities,sometimes associated with air bronchogram.The diagnosis was confirmed by lung biopsy in all the 10 cases.Bronchoscopy biopsy was conducted in 6 cases,and percutaneous lung biopsy in 3 cases.One patient received both bronchoscopy biopsy and percutaneous lung biopsy.Methylprednisolone was used in all cases.No patient received mechanical ventilation.One patient died.Conclusions AFOP is a new type of interstitial lung disease,the etiology of which is unknown.AFOP often occurs in middle-and old-aged patients.AFOP is easily misdiagnosed due to its unspecific clinical manifestations,which are similar to common pneumonia.The confirmation of AFOP diagnosis depends on pathological biopsy.Corticosteroids treatment is appropriate,but the dosage,duration,and long term effect of corticosteroids are not established.

17.
Journal of Practical Radiology ; (12): 677-680,687, 2017.
Article in Chinese | WPRIM | ID: wpr-614130

ABSTRACT

Objective To analyze the radiologic characteristics of focal organizing pneumonia (FOP) and discuss its values in diagnosis of FOP.Methods 57 lesions of FOP proved by histological examination were studied retrospectively.All of the lesions could be classified into types of nodule(diameter≤30 mm, n=40) and mass(diameter>30 mm, n=17),which were analyzed to explore the imaging characteristics such as location, margin, internal state, and enhancement features.Results 39 lesions were located in the right lung and 18 lesions in the left lung, and 51 lesions in the peripheral and 6 lesions in the inner or middle of the lung.The differences between the location of lobe and lung field were statistically significant.The radiographic common features included air bronchogram were seen in 28 cases, while loose composition sign in 18 cases and vessel convergence in 21 cases.49 lesions occurred in subpleural region, including 34 lesions broad contract with pleura.In 54 lesions with contrast-enhanced CT scan, the difference between arterial phase and plain scan in CT value was 35 HU and difference of venous phase and plain scan was 45 HU, presenting gradual enhancement.14 lesions were inhomogeneous enhancement in mass type and 25 lesions were homogeneous enhancement in nodule type.There were statistic differences in margin, shape, round-glass opacity, necrosis, cave and the relationship with pleura between the nodule type and mass type.Conclusion FOP has specific radiographic features.Enhanced CT scan combining multi planar reformation images is helpful in differential diagnosis.

19.
Journal of Rural Medicine ; : 130-134, 2017.
Article in English | WPRIM | ID: wpr-379427

ABSTRACT

<p>An 81-year-old man was referred to our hospital with bilateral multiple patchy opacities on chest radiography. His chief complaints were a few months’ history of intermittent mild cough and slightly yellow sputum. Chest computed tomography (CT) showed non-segmental air-space consolidations with ground-glass opacities. Amyloid deposition with organizing pneumonia (OP) was seen in transbronchial lung biopsy (TBLB) specimens from the left S8. Three months later, the infiltration originally seen in the left lower lobe was remarkably diminished, and new infiltrations in the lingual and right lower lobes were detected on chest CT. Amyloid deposition with OP was seen in TBLB specimens from the left S4. Transthyretin was detected following immunohistochemical examination. The presence of wild-type transthyretin (ATTRwt) was proven using genetic analysis. The present report describes a rare case of ATTRwt amyloidosis associated with OP.</p>

20.
Medicina (B.Aires) ; 76(6): 338-342, dic. 2016. ilus, tab
Article in Spanish | LILACS | ID: biblio-841606

ABSTRACT

La neumonía en organización es una entidad clínica asociada a síntomas y hallazgos radiológicos inespecíficos y anomalías en las pruebas de función pulmonar. El patrón histopatológico característico se define por tapones intra-alveolares de tejido de granulación. Puede presentarse sin una etiología determinada -neumonía en organización criptogénica (COP, cryptogenic organizing pneumonia)- o en otra condición clínica -neumonía en organización secundaria (SOP: secondary organizing pneumonia). Es poco frecuente y las manifestaciones clínico-radiológicas son poco específicas. Para su confirmación se requieren procedimientos invasivos, siendo habitual el tratamiento empírico con esteroides sistémicos ante la sospecha clínica. Se presentan 13 casos con diagnóstico histológico de neumonía en organización describiendo las características clínicas. La mediana de edad fue 76 años y la de tiempo al diagnóstico desde el inicio de los síntomas: 31 días. En 10 casos el diagnóstico fue por biopsia transbronquial (BTB). Ocho pacientes requirieron internación, 4 de ellos recibieron pulsos de esteroides y soporte ventilatorio. Uno falleció por una causa atribuible a la entidad y 5 presentaron recaídas. Disnea, tos y fiebre fueron los síntomas más frecuentes. La mayoría presentó más de un patrón tomográfico, siendo los más habituales vidrio esmerilado y consolidación alveolar. En 9 se realizó el diagnóstico de COP y en 4 de SOP. La causa secundaria en todos los casos fue toxicidad por drogas. Las características clínicas de los casos comunicados son consistentes con las series previamente publicadas. Cabe destacar la necesidad de tratamiento con dosis altas de esteroides y soporte ventilatorio en un grupo de pacientes.


Organizing pneumonia is a clinical entity asociated with nonspecific symptoms and radiological findings and abnormalities in pulmonary function tests. It is defined by the characteristic histopathological pattern: filling of alveoli and respiratory bronchioles by plugs of granulation tissue. It can be idiopathic (COP) or secondary to other causes (SOP). It is an unusual finding and the clinical and radiographic findings are nonspecific. For specific diagnosis an invasive procedure has to be done, but often empirical treatment is started when there’s a clinical suspicion. We describe the clinical characteristics of 13 patients with histological diagnosis of organizing pneumonia. Data was obtained from their medical records. The median age was 76 years and the median time to diagnosis from the onset of symptoms was 31 days. In 10 cases the diagnosis was made by transbronchial biopsy. 8 patients required hospitalization, 4 of them received high doses of steroids and 3 required ventilatory support. One patient died from a cause attributable to this entity and 5 relapsed. Dyspnea, cough and fever were the most frequent symptoms. Most patients had more than one tomographic pattern being the most common ground glass opacities and alveolar consolidation. Nine patients were diagnosed with COP and 4 with SOP. The most frequent underlying cause of SOP was drug toxicity. The clinical characteristics of the reported cases are consistent with previously published series. As an interesting feature, there was a group of patients that needed high doses of steroids and ventilatory support.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Cryptogenic Organizing Pneumonia/pathology , Lung/pathology , Thoracoscopy , Biopsy , Tomography, X-Ray Computed , Treatment Outcome , Adrenal Cortex Hormones/therapeutic use , Cryptogenic Organizing Pneumonia/complications , Cryptogenic Organizing Pneumonia/drug therapy , Cryptogenic Organizing Pneumonia/diagnostic imaging , Cough/etiology , Dyspnea/etiology , Fever/etiology , Lung/diagnostic imaging
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