Lee YJ, Kim YS. Cryptogenic organizing pneumonia associated with pregnancy: A case report. World J Clin Cases 2022; 10(6): 1946-1951 [PMID: 35317155 DOI: 10.12998/wjcc.v10.i6.1946]
Corresponding Author of This Article
Young Sun Kim, MD, PhD, Assistant Professor, Department of Obstetrics and Gynecology, Kyung Hee University Medical Center, 23, Kyung Hee Dae-ro, Dongdaemun-gu, Seoul 02447, South Korea. chacha0725@naver.com
Research Domain of This Article
Respiratory System
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Feb 26, 2022; 10(6): 1946-1951 Published online Feb 26, 2022. doi: 10.12998/wjcc.v10.i6.1946
Cryptogenic organizing pneumonia associated with pregnancy: A case report
Young Joo Lee, Young Sun Kim
Young Joo Lee, Young Sun Kim, Department of Obstetrics and Gynecology, Kyung Hee University Medical Center, Seoul 02447, South Korea
Author contributions: Kim YS designed and projected the case report; Lee YJ organized data of cases and collected and analyzed previous reports; Lee YJ and Kim YS wrote and revised the manuscript; all authors contributed to editorial changes in the manuscript; all authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Young Sun Kim, MD, PhD, Assistant Professor, Department of Obstetrics and Gynecology, Kyung Hee University Medical Center, 23, Kyung Hee Dae-ro, Dongdaemun-gu, Seoul 02447, South Korea. chacha0725@naver.com
Received: August 6, 2021 Peer-review started: August 6, 2021 First decision: November 11, 2021 Revised: November 16, 2021 Accepted: January 11, 2022 Article in press: January 11, 2022 Published online: February 26, 2022 Processing time: 201 Days and 8.2 Hours
Abstract
BACKGROUND
Cryptogenic organizing pneumonia (COP), formerly known as bronchiolitis obliterans organizing pneumonia, is an extremely rare disease in pregnancy. In this case, we report on COP diagnosed in recurrent pneumonia that does not respond to antibiotics in pregnant woman.
CASE SUMMARY
A 35-year-old woman with no prior lung disease presented with concerns of chest pain with cough, sputum, dyspnea, and mild fever at 11 wk’ gestation. She was diagnosed with community-acquired pneumonia and treated with antibiotics; her symptoms improved temporarily. Four weeks after discharge, she was re-admitted with aggravated symptoms. Chest computed tomography demonstrated multifocal patchy airspace consolidation and ground-glass opacities at the basal segments of the right lower lobe, at the lateral basal segment of the lower lobe, and at the lingular segment of the left upper lobe. Bronchoalveolar lavage revealed an increased lymphocyte count and a decreased CD4/CD8 ratio. Prednisolone (0.5 mg/kg/d) was administered for 10 d after the second admission. Dyspnea improved after 3 d of steroid treatment and other symptoms improved on the 5th day of steroid administration. Post-delivery transbronchial lung biopsy further revealed the presence of granulation tissue with fibroblasts in small-bronchiole lumens.
CONCLUSION
This case suggests that it is important to differentiate COP from atypical pneumonia in the deteriorated condition despite antibiotic treatment.
Core Tip: Cryptogenic organizing pneumonia (COP) is a diffuse infiltrating lung disease, wherein granulation tissue proliferates in the small bronchiolar epithelium. The COP is an extremely rare in pregnancy. We present the fourth case of COP during pregnancy. This case highlights that it is important to differentiate COP from other types of pneumonia that does not respond and aggravated despite of empirical antibiotics in pregnant woman. The corticosteroid administration is effective in the treatment of COP during pregnancy.
