Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2018; 6(15): 1053-1058
Published online Dec 6, 2018. doi: 10.12998/wjcc.v6.i15.1053
Successful steroid treatment for acute fibrinous and organizing pneumonia: A case report
Ya-Jing Ning, Pei-Shan Ding, Zhang-Yan Ke, Yan-Bei Zhang, Rong-Yu Liu
Ya-Jing Ning, Pei-Shan Ding, Zhang-Yan Ke, Yan-Bei Zhang, Rong-Yu Liu, Department of Geriatric Respiratory and Critical Care, the First Affiliated Hospital of Anhui Medical University, Hefei 230000, Anhui Province, China
Author contributions: Ning YJ, Ding PS and Ke ZY collected clinical data and wrote the paper; Zhang YB and Liu RY helped to design and revise the paper.
Informed consent statement: Informed consent was obtained from the patient before all procedures described in the report as well as for the use of the patient’s clinical information and images for publication.
Conflict-of-interest statement: The authors declare that there is no conflict of interest related to this report.
Open-Access: 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/
Correspondence to: Rong-Yu Liu, MD, PhD, Chief Doctor, Professor, Department of Geriatric Respiratory and Critical Care, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Street, Hefei 230000, Anhui Province, China. rongyuliu@163.com
Telephone: +86-551-65120742 Fax: +86-551-65120742
Received: September 8, 2018
Peer-review started: September 10, 2018
First decision: October 11, 2018
Revised: October 28, 2018
Accepted: October 31, 2018
Article in press: November 1, 2018
Published online: December 6, 2018
Processing time: 89 Days and 22 Hours
Abstract
BACKGROUND

Since the acute fibrinous and organizing pneumonia (AFOP) was first described by Beasley in 2002, some case reports of patients aged from 38 d to 80 years have been published worldwide, but there is still no standard therapy for this disease and the treatment methods remain controversial. Both steroid and immunosuppressive agents, such as cyclophosphamide or mycophenolate mofetil, have been reported to be effective in some studies, but with many side effects, especially in patients of advanced age.

CASE SUMMARY

We herein report an 81-year-old female patient who was admitted to our hospital due to dry cough, and breathlessness for 1 mo. She was treated with broad-spectrum antibiotics and anti-fungal therapy, but without improvement in both symptoms and radiological findings, and her respiratory status worsened, and she required bed rest almost the whole day. Computed tomography-guided percutaneous needle lung biopsy was performed and histopathology examination confirmed the diagnosis of AFOP. She was then successfully treated with a steroid monotherapy, which resulted in a satisfactory clinical outcome without serious complications.

CONCLUSION

We conclude that complete remission of AFOP can be achieved by steroid monotherapy in patients of advanced age.

Keywords: Acute fibrinous and organizing pneumonia; Geriatric; Steroid; Computed tomography-guided percutaneous needle lung biopsy; Case report

Core tip: Acute fibrinous and organizing pneumonia is a rare histological pattern of acute lung injury. The age of the patients was diverse from infant to elderly, and there is still no specific therapy. Although treatments with steroids combined with immunosuppressants have been reported, none of them showed particular benefit, and these treatments always induce serious side effects, especially in patients of advanced age. We herein report an 81-year-old female patient, who was successfully treated with low-dose steroids, and only experienced some minor side-effects. This case report can add a new treatment choice for this disease.