Acute fibrinous and organizing pneumonia in systemic lupus erythematosus: A case report and review of the literature
Acute fibrinous and organizing pneumonia in systemic lupus erythematosus: A case report and review of the literature
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DOI：
10.1111/j.1440-1827.2010.02586.x
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发表时间：
2010-11-01
影响因子：
2.2
通讯作者：
Mark, Eugene J.
中科院分区：
文献类型：
--
作者：
Hariri, Lida P.;Unizony, Sebastian;Mark, Eugene J.
系统性红斑狼疮(SLE)的肺部表现通常包括胸膜炎、肺泡出血和免疫抑制引起的感染性肺炎，较少见的实体包括毛细支气管炎、间质性肺炎和肺纤维化。更罕见的表现包括机化性肺炎(OP)和弥漫性肺泡损伤(DAD)。一种相似但不同的急性纤维蛋白和机化性肺炎(AFOP)，其特征是肺泡内纤维蛋白沉积和相关机化性肺炎，已被报道与结缔组织疾病有关，但尚未被描述与SLE有关。本文报告一例系统性红斑狼疮并伴有抗磷脂综合征的患者，最近有肺栓塞、持续的呼吸道症状和持续的放射学异常，经肺活检证实有AFOP的特征。此病例结合以前的文献表明，AFOP可以是包括SLE在内的结缔组织疾病的一种表现，由于与OP和DAD的组织学特征重叠，AFOP可能是内科肺部疾病的一种未被报道的变体。
Pulmonary manifestations of systemic lupus erythematosus (SLE) typically include pleuritis, alveolar hemorrhage, and infectious pneumonia due to immunosuppression with less common entities including bronchiolitis, interstitial pneumonia, and pulmonary fibrosis. More rare manifestations include organizing pneumonia (OP) and diffuse alveolar damage (DAD). A similar but distinct entity of acute fibrinous and organizing pneumonia (AFOP), characterized by intra-alveolar fibrin deposition and associated organizing pneumonia, has been reported in association with connective tissue disorders, but has not been described in association with SLE. Reported herein is a patient with SLE and accompanying antiphospholipid syndrome with recent pulmonary embolism, persistent respiratory symptomology, and persistent radiographic abnormalities who underwent lung biopsy displaying features of AFOP. This case in conjunction with previous literature indicates that AFOP can be a manifestation of connective tissue disease including SLE and may be an underreported variant of medical lung disease due to overlap in histological characteristics with OP and DAD.