A Cryptogenic Case of Fulminant Fibrosing Organizing Pneumonia

Intern Med. 2017;56(10):1185-1191. doi: 10.2169/internalmedicine.56.7371. Epub 2017 May 15.

Abstract

Cryptogenic organizing pneumonia (COP) generally responds well to corticosteroids with a favorable outcome. Rare cases of organizing pneumonia are rapidly progressive. Yousem et al. studied pathologic predictors of idiopathic bronchiolitis obliterans organizing pneumonia/COP with an unfavorable prognosis. Beardsley and Rassl proposed the name fibrosing organizing pneumonia (FOP). A 74-year-old female non-smoker presented with a 2-week history of dry cough followed by dyspnea and a fever. The clinical course was fulminant, but we successfully performed bronchoscopy. After the diagnosis of FOP, we treated the patient with mechanical ventilation and high-doses of steroids/immunosuppressants, which improved the disease.

Keywords: bronchoscopy; cryptogenic organizing pneumonia (COP); fibrosing organizing pneumonia (FOP); rapidly progressive bronchiolitis obliterans organizing pneumonia.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Aged
  • Cryptogenic Organizing Pneumonia / diagnosis*
  • Cryptogenic Organizing Pneumonia / physiopathology*
  • Cryptogenic Organizing Pneumonia / therapy
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Prognosis
  • Respiration, Artificial

Substances

  • Adrenal Cortex Hormones
  • Immunosuppressive Agents