Acute fibrinous and organising pneumonia.
Acute fibrinous and organising pneumonia.
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DOI：
10.1136/bcr-2016-218802
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发表时间：
2017-09-07
期刊：
影响因子：
0.9
通讯作者：
Cardoso, Leila
中科院分区：
文献类型：
--
作者：
Goncalves, Joao Rocha;Marques, Ricardo;Cardoso, Leila
急性纤维蛋白性机化性肺炎（AFOP）是一种罕见的间质性肺疾病的组织学模式。作者描述了一名 60 岁女性因持续发烧入院，胸部 X 光检查显示肺泡混浊，推测诊断为社区获得性肺炎并开始使用抗生素。由于血清学结果表明嗜肺军团菌是传染源，她出院时服用左氧氟沙星。一周后，她因发烧再次入院。 CT 扫描显示新月形形态的混浊和中央磨玻璃区域，提示隐源性机化性肺炎。微生物学、血清学和自身免疫测试均为阴性。她接受了外科肺活检，结果显示肺泡腔内有炎症浸润、巨噬细胞脱落、成纤维细胞增殖和纤维蛋白沉积，与 AFOP 一致。她开始皮质治疗并取得良好反应。停药 10 个月后，疾病复发。目前，患者每天服用 5 毫克泼尼松龙，未出现临床和放射学复发。
Acute fibrinous and organising pneumonia (AFOP) is a rare histological pattern of interstitial lung disease. The authors describe a 60-year-old woman admitted to the hospital for sustained fever, presenting with an alveolar opacity on chest X-ray, with the presumed diagnosis of community-acquired pneumonia and the onset of antibiotics. Since serological results suggested that Legionella pneumophila was the infectious agent, she was discharged on levofloxacin. A week later, she was again admitted with fever. CT scan showed opacities with crescentic morphology and a central ground-glass area suggestive of cryptogenic organising pneumonia. Microbiological, serological and autoimmunity tests were negative. She underwent surgical lung biopsy that revealed inflammatory infiltrate, macrophage desquamation, fibroblasts proliferation and fibrin deposition in the alveolar spaces, consistent with AFOP. She started corticotherapy with good response. Disease relapsed after prednisolone discontinuation, 10 months later. Currently, the patient is on prednisolone 5mg/day without clinical and radiological recurrence.