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1.
Rev. patol. respir ; 26(2): 27-29, Abr-Jun 2023. ilus
Artigo em Espanhol | IBECS | ID: ibc-222256

RESUMO

La neumonía organizativa es un patrón histológico que puede observarse asociado o reactivo en diferentes patologías.Presentamos el caso de una mujer de 67 años con diagnóstico inicial de neumonía organizada criptogénica, sin respuestaa los glucocorticoides y autoinmunidad negativa. Finalmente, la neumonía organizada resultó ser secundaria a neoplasiahematológica. En estos casos es importante insistir en la anamnesis y realizar los procedimientos necesarios para conseguirel diagnóstico definitivo.(AU)


Organizational pneumonia is a histological pattern that can be observed associated or reactive in different pathologies. Wepresent the case of a 67-year-old woman with an initial diagnosis of organized pneumonia, no response to glucocorticoidsand negative autoimmunity. Finally, organized pneumonia was found to be secondary to hematologic malignancy. In thesecases, it is important to insist on the anamnesis and perform the necessary procedures to achieve the definitive diagnosis.(AU)


Assuntos
Humanos , Feminino , Idoso , Doenças Pulmonares Intersticiais , Pneumonia em Organização Criptogênica/diagnóstico , Pneumonia em Organização Criptogênica/terapia , Neoplasias Hematológicas , Anamnese , Doenças Respiratórias , Resultado do Tratamento , Pacientes Internados , Exame Físico , Avaliação de Sintomas
2.
Galicia clin ; 83(2): 38-40, Apr-May-Jun 29/06/2022.
Artigo em Espanhol | IBECS | ID: ibc-206340

RESUMO

We present the case of a women previously diagnosed with nodularpanniculitis (biopsy compatible with neutrophilic dermatosis) andmultifactorial anemia with signs of hemolysis and splenomegaly,who refers reappearance of painful nodules in extremities and general syndrome. The differential diagnosis of the coexistence of these alterations is proposed, with the subsequent solution of the case. (AU)


Presentamos el caso de una mujer con diagnóstico previo de paniculitis nodular con biopsia compatible con dermatosis neutrofílicay anemia multifactorial con componente hemolítico asociada a esplenomegalia, que consulta por reaparición de nódulos dolorososen extremidades y síndrome general. Se plantea el diagnóstico diferencial de la aparición conjunta de estas alteraciones y posteriorresolución del caso clínico. (AU)


Assuntos
Humanos , Feminino , Idoso , Paniculite Nodular não Supurativa/diagnóstico , Paniculite Nodular não Supurativa/terapia , Esplenomegalia/diagnóstico , Esplenomegalia/terapia , Anemia Hemolítica/diagnóstico , Pneumonia em Organização Criptogênica/diagnóstico , Pneumonia em Organização Criptogênica/terapia
3.
Dtsch Med Wochenschr ; 146(13-14): 927-932, 2021 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-34256411

RESUMO

Acute COVID-19 pneumonia may result in persistent changes with various imaging and histopathological patterns, including organizing pneumonia and pulmonary fibrosis. In addition, SARS-CoV-2 infection is associated with increased risk of pulmonary vascular endothelialitis and thrombosis. Herein, current findings on pulmonary consequences of COVID-19 with implications for clinical management are summarized based on a selective literature review.


Assuntos
COVID-19/complicações , Pneumonia em Organização Criptogênica/complicações , Pneumonia Viral/complicações , Fibrose Pulmonar/complicações , Doença Aguda , COVID-19/diagnóstico por imagem , COVID-19/terapia , Pneumonia em Organização Criptogênica/diagnóstico por imagem , Pneumonia em Organização Criptogênica/terapia , Seguimentos , Humanos , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/terapia , Fibrose Pulmonar/diagnóstico por imagem , Fibrose Pulmonar/terapia
4.
Medicine (Baltimore) ; 100(26): e26449, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34190169

RESUMO

RATIONALE: Anaplastic lymphoma kinase (ALK) inhibitors have been approved for patients with ALK-rearrangement lung cancer. The effect is superior to the standard first-line therapy of pemetrexed plus platinum-based chemotherapy. However, ALK inhibitors are associated with rare and sometimes fatal adverse events. Organizing pneumonitis (OP) is a rare and serious adverse event usually caused by ceritinib, and it is easily misdiagnosed as infectious pneumonia, metastasis, or cancer progression. PATIENT CONCERNS: A 56-year-old female presented with chest tightness and dyspnea for more than 10 days. She was previously healthy with no significant medical history. Workup including chest computed tomography (CT), pathological examination of a biopsy specimen, and next-generation sequencing was consistent with a diagnosis of IVA ALK-rearrangement lung adenocarcinoma. She was treated with pemetrexed plus platinum-based chemotherapy and crizotinib concurrently, followed by maintenance therapy with crizotinib alone and she had an almost complete response. However, about 26 months after beginning treatment she developed multiple brain metastases. Crizotinib was discontinued and she was begun on ceritinib. After about 3 months the brain metastases had almost complete response. After 5 months of ceritinib, however, multiple patchy lesions appeared in the bilateral upper lungs. DIAGNOSES: Treatment with antibiotics had no effect and blood and sputum cultures are negative. A CT-guided biopsy of the upper lung was performed, and pathological hematoxylin-eosin staining and immunohistochemical studies were consistent with OP. INTERVENTIONS: Ceritinib was discontinued, she was begun on prednisone 0.5 mg/kg orally every day, and regular follow-up is necessary. OUTCOMES: CT of the chest 2 and 4 weeks after beginning prednisone showed the lung lesions to be gradually resolving, and she was continued on prednisone for 2 months and gradually reduced the dose of prednisone every 2 weeks. No related adverse events were occurred in patient. LESSONS: OP must be differentiated from infectious pneumonia, metastasis, or cancer progression. The mechanism of OP is still unknown and needs further research. Biopsy plays a role in making a diagnosis of OP. In our patient, discontinuing ceritinib and treating her with prednisone resulted in a good outcome.


Assuntos
Adenocarcinoma de Pulmão , Quinase do Linfoma Anaplásico , Pneumonia em Organização Criptogênica , Neoplasias Pulmonares , Prednisona/administração & dosagem , Pirimidinas , Sulfonas , Adenocarcinoma de Pulmão/tratamento farmacológico , Adenocarcinoma de Pulmão/genética , Adenocarcinoma de Pulmão/patologia , Adenocarcinoma de Pulmão/fisiopatologia , Quinase do Linfoma Anaplásico/antagonistas & inibidores , Quinase do Linfoma Anaplásico/genética , Antineoplásicos/uso terapêutico , Biópsia/métodos , Neoplasias Encefálicas/tratamento farmacológico , Neoplasias Encefálicas/secundário , Crizotinibe/uso terapêutico , Pneumonia em Organização Criptogênica/induzido quimicamente , Pneumonia em Organização Criptogênica/patologia , Pneumonia em Organização Criptogênica/terapia , Substituição de Medicamentos , Inibidores Enzimáticos/administração & dosagem , Inibidores Enzimáticos/efeitos adversos , Feminino , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Humanos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/fisiopatologia , Pessoa de Meia-Idade , Pemetrexede/uso terapêutico , Pirimidinas/administração & dosagem , Pirimidinas/efeitos adversos , Sulfonas/administração & dosagem , Sulfonas/efeitos adversos , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
5.
Chest ; 159(3): e147-e150, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33678282

RESUMO

CASE PRESENTATION: A 69-year-old woman with a medical history significant for COPD, ulcerative colitis (UC), and tobacco dependence was referred to a pulmonologist for lung nodules found on routine annual low-dose CT scan for lung cancer screening. Her review of systems was negative for dyspnea, angina, hemoptysis, fever, night sweats, anorexia, and weight loss. She had a successful total proctocolectomy with ileal pouch-anal anastomosis performed 5 years ago because of acute fulminant UC refractory to corticosteroids and biologic agents. Her home medications were albuterol inhaler, umeclidinium, and vilanterol inhalation powder. She denied any history of lung cancers in her family. She was an active smoker and had a 35-pack-year smoking history. She worked as a cashier in a local supermarket and had been doing so for the past 25 years.


Assuntos
Colite Ulcerativa , Pneumonia em Organização Criptogênica , Nódulos Pulmonares Múltiplos/diagnóstico por imagem , Prednisona/administração & dosagem , Idoso , Anti-Inflamatórios/administração & dosagem , Biópsia/métodos , Colite Ulcerativa/complicações , Colite Ulcerativa/cirurgia , Pneumonia em Organização Criptogênica/diagnóstico , Pneumonia em Organização Criptogênica/etiologia , Pneumonia em Organização Criptogênica/terapia , Diagnóstico Diferencial , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Achados Incidentais , Nódulos Pulmonares Múltiplos/patologia , Tomografia por Emissão de Pósitrons/métodos , Proctocolectomia Restauradora/métodos , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/terapia , Abandono do Hábito de Fumar , Tabagismo , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Imagem Corporal Total/métodos
9.
Cancer Radiother ; 21(5): 411-423, 2017 Aug.
Artigo em Francês | MEDLINE | ID: mdl-28596060

RESUMO

Radiation-induced lung injuries mainly include the (acute or sub-acute) radiation pneumonitis, the lung fibrosis and the bronchiolitis obliterans organizing pneumonia (BOOP). The present review aims at describing the diagnostic process, the current physiopathological knowledge, and the available (non dosimetric) preventive and curative treatments. Radiation-induced lung injury is a diagnosis of exclusion, since clinical, radiological, or biological pathognomonic evidences do not exist. Investigations should necessarily include a thoracic high resolution CT-scan and lung function tests with a diffusing capacity of the lung for carbon monoxide. No treatment ever really showed efficacy to prevent acute radiation-induced lung injury, or to treat radiation-induced lung fibrosis. The most promising drugs in order to prevent radiation-induced lung injury are amifostine, angiotensin-converting-enzyme inhibitors and pentoxifylline. Inhibitors of collagen synthesis are currently tested at a pre-clinical stage to limit the radiation-induced lung fibrosis. Regarding available treatments of radiation-induced pneumonitis, corticoids can be considered the cornerstone. However, no standardized program or guidelines concerning the initial dose and the gradual tapering have been scientifically established. Alternative treatments can be prescribed, based on clinical cases reporting on the efficacy of immunosuppressive drugs. Such data highlight the major role of the lung dosimetric protection in order to efficiently prevent radiation-induced lung injury.


Assuntos
Pneumonia em Organização Criptogênica/etiologia , Pneumonia em Organização Criptogênica/terapia , Fibrose Pulmonar/etiologia , Fibrose Pulmonar/terapia , Lesões por Radiação/terapia , Pneumonite por Radiação/terapia , Pneumonia em Organização Criptogênica/diagnóstico , Pneumonia em Organização Criptogênica/fisiopatologia , Pneumonia em Organização Criptogênica/prevenção & controle , Humanos , Fibrose Pulmonar/diagnóstico , Fibrose Pulmonar/fisiopatologia , Fibrose Pulmonar/prevenção & controle , Lesões por Radiação/diagnóstico , Lesões por Radiação/fisiopatologia , Lesões por Radiação/prevenção & controle , Pneumonite por Radiação/diagnóstico , Pneumonite por Radiação/fisiopatologia , Pneumonite por Radiação/prevenção & controle
10.
Intern Med ; 56(10): 1185-1191, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28502934

RESUMO

Cryptogenic organizing pneumonia (COP) generally responds well to corticosteroids with a favorable outcome. Rare cases of organizing pneumonia are rapidly progressive. Yousem et al. studied pathologic predictors of idiopathic bronchiolitis obliterans organizing pneumonia/COP with an unfavorable prognosis. Beardsley and Rassl proposed the name fibrosing organizing pneumonia (FOP). A 74-year-old female non-smoker presented with a 2-week history of dry cough followed by dyspnea and a fever. The clinical course was fulminant, but we successfully performed bronchoscopy. After the diagnosis of FOP, we treated the patient with mechanical ventilation and high-doses of steroids/immunosuppressants, which improved the disease.


Assuntos
Pneumonia em Organização Criptogênica/diagnóstico , Pneumonia em Organização Criptogênica/fisiopatologia , Corticosteroides/uso terapêutico , Idoso , Pneumonia em Organização Criptogênica/terapia , Feminino , Humanos , Imunossupressores/uso terapêutico , Prognóstico , Respiração Artificial
11.
Cancer Radiother ; 21(2): 148-154, 2017 Apr.
Artigo em Francês | MEDLINE | ID: mdl-28385367

RESUMO

Bronchiolitis obliterans with organizing pneumonia is an inflammatory reaction that can occur as a consequence of various pulmonary affections. Radiotherapy is not the sole and systematic cause of bronchiolitis obliterans with organizing pneumonia. Radiation-induced should not be confused with post-radiation, dose-dependent, inflammatory pulmonary fibrosis, which is non-immunological and located within the irradiation field. The role of immunity, local inflammation and individual radiosensitivity in bronchiolitis obliterans with organizing pneumonia is not well defined. Bronchiolitis obliterans with organizing pneumonia represents 1% of irradiated patients with breast cancer. It results in fever (flu-like symptoms), a rather dry cough and dyspnea. In the post-radiation context, bronchiolitis obliterans with organizing pneumonia may be diagnosed several months and up to a year after breast irradiation. The treatment consists of prolonged steroids or immunosuppressants, which do not prevent chronicity in 15% of patients and death in up to 5% of cases, the remaining 80% of patients healing without sequelae.


Assuntos
Pneumonia em Organização Criptogênica/etiologia , Lesões por Radiação/complicações , Idoso , Pneumonia em Organização Criptogênica/diagnóstico , Pneumonia em Organização Criptogênica/epidemiologia , Pneumonia em Organização Criptogênica/terapia , Feminino , Humanos , Prevalência
12.
Rev Mal Respir ; 33(8): 703-717, 2016 Oct.
Artigo em Francês | MEDLINE | ID: mdl-26857200

RESUMO

INTRODUCTION: Organizing pneumonia is a particular type of inflammatory reaction of the lung which gives rise to a clinico-pathological syndrome. It is called "secondary" when a cause such as an infection, a drug toxicity, or a connective tissue disease can be identified, or "cryptogenic" when no cause is identified. The clinical picture is usually characterized by the subacute onset of fever, fatigue, cough and dyspnea, with multiple subpleural areas of consolidation on thoracic imaging. STATE OF THE ART: Organizing pneumonia is characterised by the presence of buds of endoalveolar connective tissue. These result from an injury to the alveolar epithelium, followed by the deposition of fibrin in the alveolar spaces, and the migration of fibroblasts which produce a myxoid endoalveolar matrix. A remarkable feature of organizing pneumonia is the complete disappearance of these endoalveolar buds with corticosteroid treatment, in sharp contrast with what is seen in pulmonary fibrosis. The clinical response to corticosteroids is usually prompt and excellent. Relapses are frequent but usually benign. PERSPECTIVES AND CONCLUSION: As the clinical, imaging and pathological characteristics of organizing pneumonia are now well established, many questions remain unanswered, such as the mechanisms involved in the complete reversibility of the pulmonary lesions, and the role of steroid-sparing treatments such as immunomodulatory macrolides.


Assuntos
Pneumonia em Organização Criptogênica , Pneumonia em Organização Criptogênica/classificação , Pneumonia em Organização Criptogênica/diagnóstico , Pneumonia em Organização Criptogênica/patologia , Pneumonia em Organização Criptogênica/terapia , Diagnóstico Diferencial , Glucocorticoides/uso terapêutico , Humanos , Recidiva , Terminologia como Assunto
13.
J Med Case Rep ; 10: 15, 2016 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-26791087

RESUMO

BACKGROUND: Myelodysplasia syndrome is a heterogeneous group of hematological disorders that are characterized by abnormal morphology and cytopenias of bone marrow elements. Azacitidine is a hypomethylating agent that is commonly used in treatment of myelodysplasia syndrome. We present an extremely rare case of cryptogenic organizing pneumonia following therapy with azacitidine and a review of the relevant literature. This is the fifth case of azacitidine-induced interstitial lung disease and the sixth one due to hypomethylating drugs; of interest, this is the first reported case that has occurred after the second cycle. Our case report highlights an important, potentially treatable and rare side effect of azacitidine and hypomethylating agents in general that might be overlooked by oncologists. Furthermore, our review of the literature showed heterogeneity in the clinical outcome which might, in part, be due to delay in initiating corticosteroids treatment. CASE PRESENTATION: A 67-year-old white man presented with worsening shortness of breath and mild productive cough that started 1 week prior to his presentation. An initial chest X-ray showed infiltration of both lung fields. Radiographic findings of computed axial tomography, results of bronchoscopy and a lung biopsy were consistent with cryptogenic organizing pneumonia. The patient showed variable clinical response to steroids and he remained dependent on home oxygen. CONCLUSIONS: We concluded that there is a recognizable potentially life-threatening toxicity due to organizing pneumonia secondary to azacitidine in the setting of myelodysplasia syndrome treatment. This toxicity is not limited to the first cycle as in previous cases; furthermore, pleural effusion can be associated with this toxicity. Health care professionals should be aware of this recognizable side effect. Early recognition and timely management are critical to prevent permanent lung fibrosis.


Assuntos
Corticosteroides/uso terapêutico , Antimetabólitos Antineoplásicos/efeitos adversos , Azacitidina/efeitos adversos , Pneumonia em Organização Criptogênica/induzido quimicamente , Pulmão/patologia , Síndromes Mielodisplásicas/tratamento farmacológico , Antimetabólitos Antineoplásicos/administração & dosagem , Azacitidina/administração & dosagem , Broncoscopia/métodos , Tosse/etiologia , Pneumonia em Organização Criptogênica/complicações , Pneumonia em Organização Criptogênica/fisiopatologia , Pneumonia em Organização Criptogênica/terapia , Serviços de Assistência Domiciliar , Humanos , Pulmão/diagnóstico por imagem , Pulmão/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Oxigenoterapia , Radiografia , Resultado do Tratamento
15.
Immunol Res ; 61(1-2): 97-103, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25480740

RESUMO

Bronchiolitis obliterans organizing pneumonia (BOOP) is defined by buds of granulation tissue within lung distal airspaces. The diagnosis requires the histopathologic evidence of organizing pneumonia along with a suggestive clinical and radiographic pattern. This disorder is characterized by a good response to corticosteroids and an excellent prognosis. It can occur in association with a broad spectrum of clinical conditions or can be isolated, in this last case named cryptogenic organizing pneumonia. We searched for BOOP in patients with autoimmune rheumatic diseases (ARD) in the literature, and we found 32 well-documented cases. We reported here demographic features, manifestations, treatment and outcome of patients with BOOP associated with ARD. Notably, BOOP can be the presenting feature in some patients with ARD; thus, a close follow-up of patients with BOOP is recommended.


Assuntos
Doenças Autoimunes/complicações , Pneumonia em Organização Criptogênica/complicações , Pneumonia em Organização Criptogênica/diagnóstico , Doenças Reumáticas/complicações , Doenças Autoimunes/diagnóstico , Pneumonia em Organização Criptogênica/epidemiologia , Pneumonia em Organização Criptogênica/terapia , Humanos , Doenças Reumáticas/diagnóstico
16.
Korean J Intern Med ; 29(6): 746-53, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25378973

RESUMO

BACKGROUND/AIMS: Amiodarone is one of the most widely used antiarrhythmic agents; however, amiodarone-induced pulmonary toxicity (APT) can be irreversible and sometimes fatal. The aim of this study was to evaluate the feasibility of chest computed tomography (CT) as a diagnostic tool for APT and to assess the utility of the CT APT score as an index for predicting the severity of APT. METHODS: Patients underwent amiodarone treatment for various reasons, most often atrial fibrillation, for more than 2 years, and those that received a cumulative dose > 100 g were enrolled. A total of 34 patients who underwent chest CT between December 2011 and June 2012 were enrolled, whether or not they had clinical symptoms. The APT CT score was defined as the number of involved regions in the lung, which was divided into 18 regions (right and left, upper, middle, and lower, and central, middle, and peripheral). The CT findings were evaluated according to the total dose and duration of amiodarone treatment and the results of a pulmonary function test. Clinical symptoms and outcomes were also evaluated according to APT CT scores. RESULTS: Seven patients had positive APT CT scores (interstitial fibrosis in five, organizing pneumonia in one, and mixed interstitial fibrosis and organizing pneumonia in one), and these patients exhibited significantly lower diffusion capacity for carbon monoxide in the lungs compared with patients without an increased APT CT score (70.2% ± 6.9% vs. 89.7% ± 19.4%; p = 0.011). Three of the seven patients experienced overt APT that required hospital admission. CONCLUSIONS: Chest CT is a useful diagnostic tool for APT, and the APT CT score might be a useful index for assessing the severity of APT.


Assuntos
Amiodarona/efeitos adversos , Antiarrítmicos/efeitos adversos , Fibrilação Atrial/tratamento farmacológico , Pneumonia em Organização Criptogênica/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Fibrose Pulmonar/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Idoso , Fibrilação Atrial/diagnóstico , Estudos Transversais , Pneumonia em Organização Criptogênica/induzido quimicamente , Pneumonia em Organização Criptogênica/fisiopatologia , Pneumonia em Organização Criptogênica/terapia , Estudos de Viabilidade , Feminino , Volume Expiratório Forçado , Hospitalização , Humanos , Pulmão/efeitos dos fármacos , Pulmão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Capacidade de Difusão Pulmonar , Fibrose Pulmonar/induzido quimicamente , Fibrose Pulmonar/fisiopatologia , Fibrose Pulmonar/terapia , Testes de Função Respiratória , Fatores de Risco , Fatores de Tempo , Capacidade Vital
17.
Rev Clin Esp (Barc) ; 214(5): 258-65, 2014.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-24332510

RESUMO

A 56-year-old woman, non-smoker, who complained of dry cough and dyspnea during the last month came to the emergency department due to increased dyspnea. The chest X-ray showed areas of poorly defined, bilateral alveolar opacities, leading to the diagnosis of bronchopneumonia with partial respiratory failure. During admission, she experienced an exacerbation of the dyspnea. A high-resolution computed tomography scan was performed, showing areas of ground glass opacities with interlobular septal thickening ("crazy-paving" pattern), predominantly in lower lobes. She required mechanical ventilation and she was admitted to the intensive care unit. Subsequently, an open lung biopsy was performed. The following questions should be proposed:


Assuntos
Pneumonia em Organização Criptogênica/diagnóstico , Respiração Artificial/métodos , Tomografia Computadorizada por Raios X/métodos , Biópsia/métodos , Tosse/etiologia , Cuidados Críticos , Pneumonia em Organização Criptogênica/diagnóstico por imagem , Pneumonia em Organização Criptogênica/terapia , Dispneia/etiologia , Feminino , Humanos , Pessoa de Meia-Idade
18.
Rev Med Suisse ; 9(407): 2164-9, 2013 Nov 20.
Artigo em Francês | MEDLINE | ID: mdl-24354251

RESUMO

Cryptogenic organizing pneumonia (COP) is a distinct clinico-pathologic entity described for the first time by Davison in 1983 and 2 years later by Epler under the name of idiopathic Bronchiolitis Obliterans Organizing Pneumonia (BOOP). It most often presents with the clinical and radiological features of an infectious pneumonia which fails to respond to antibiotic therapy. In this article, we will review the clinical and radiographic features, diagnostic assessment, and the treatment of COP.


Assuntos
Pneumonia em Organização Criptogênica/fisiopatologia , Pneumonia/diagnóstico , Antibacterianos/uso terapêutico , Pneumonia em Organização Criptogênica/diagnóstico , Pneumonia em Organização Criptogênica/terapia , Diagnóstico Diferencial , Humanos , Pneumonia/tratamento farmacológico , Prognóstico , Resultado do Tratamento
19.
J Pediatr Hematol Oncol ; 35(2): 139-43, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23337545

RESUMO

INTRODUCTION: Acute fibrinous and organizing pneumonia (AFOP) is a recently described histologic pattern of diffuse pulmonary disease. In children, all cases reported to date have been fatal. In this study, we describe the first nonfatal AFOP in a child and review the literature. DESCRIPTION: A 10-year-old boy developed very severe aplastic anemia (VSAA) after being admitted to our hospital with a fulminant hepatic failure of unknown origin. A chest computed tomography scan revealed multiple lung nodules and a biopsy of a pulmonary lesion showed all the signs of AFOP. Infectious workup remained negative. We started immunosuppressive therapy with antithymocyte globulin and cyclosporine to treat VSAA. Subsequent chest computed tomography scans showed a considerable diminution of the lung lesions but the VSAA did not improve until we performed hematopoietic stem cell transplantation 5 months later. CONCLUSIONS: Aplastic anemia is associated with a variety of autoimmune syndromes. The sequence of events in our patient suggests that the hepatic failure, AFOP, and the VSAA may all have been part of an autoimmune syndrome. AFOP could be the result of immune dysregulation in this pediatric case with favorable outcome after immunosuppressive therapy and hematopoietic stem cell transplantation.


Assuntos
Pneumonia em Organização Criptogênica/imunologia , Doenças do Sistema Imunitário/complicações , Doença Aguda , Criança , Pneumonia em Organização Criptogênica/etiologia , Pneumonia em Organização Criptogênica/terapia , Transplante de Células-Tronco Hematopoéticas , Humanos , Imunossupressores/uso terapêutico , Masculino
20.
Ter Arkh ; 84(3): 38-44, 2012.
Artigo em Russo | MEDLINE | ID: mdl-22708421

RESUMO

According to current classifications, organizing pneumonia (OP) belongs to the group of diffuse parenchymatous diseases of the lungs. Morphological picture of OP is characterized by the presence of polypoid granulation tissue consisting of proliferating fibroblasts and myofibroblasts in the gap of respiratory bronchioles. In most cases OP is idiopathic. Among the causes, most significant are diffuse diseases of the connective tissue and complications of pharmacotherapy. OP develops more frequently in 50-60-year old males and females. Typical for OP is an acute/subacute course with a clinical picture of bacterial pneumonia. Mean duration of the symptoms to diagnosis is 2-6 months. Roentgenologically, OP often presents with spotted bilateral (less often unilateral) dense consolidation foci of subpleural location; pulmonary volumes are, as a rule, unaffected. OP treatment of choice is administration of glucocorticosteroid drugs. The prognosis of OP is favourable, most of the patients are completely cured by glucocorticosteroids.


Assuntos
Pneumonia em Organização Criptogênica/diagnóstico , Pneumonia em Organização Criptogênica/terapia , Pneumonia em Organização Criptogênica/tratamento farmacológico , Pneumonia em Organização Criptogênica/fisiopatologia , Humanos
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