Published online Dec 6, 2018. doi: 10.12998/wjcc.v6.i15.1053
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
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.
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.
We conclude that complete remission of AFOP can be achieved by steroid monotherapy in patients of advanced age.
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.