Comparison of Clinical Features and Prognosis in Patients With Cryptogenic and Secondary Organizing Pneumonia

Organizing pneumonia (OP) can be diagnosed pathologically, and cryptogenic OP (COP) and secondary OP (SOP) have been classified by cause and underlying context. Because it is clinically difficult to differentiate between COP and SOP, this study investigated characteristics that could distinguish between COP and SOP. The medical records of patients who underwent lung biopsy from 2016 to 2018 were retrospectively reviewed. Eighty-five patients had pathologically proven OP, including 16 diagnosed with COP and 69 diagnosed with SOP. The most common cause of SOP was infectious pneumonia, observed in 57 (82.6%) of the 69 patients. Median time from symptom onset to hospital admission is shorter (P=0.006) and fever was more common (P=0.021) in the SOP. Some laboratory results differed significantly between the two groups. Lymphocyte in bronchoalveolar lavage fluid were higher in the COP (P=0.012). Radiologic findings showed that effusion was more common in the SOP (P=0.043). There were no between-group differences in steroid use, 30 day and in-hospital mortality rates, and rates of OP outcomes and recurrences. Infection is the main cause of SOP. Symptom onset is more rapid in patients with SOP. Pleural effusion was more common in the SOP but there were no differences in clinical course.

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Comparison of clinical features and prognosis in patients with cryptogenic and secondary organizing pneumonia

BMC Pulmonary Medicine ◽

10.1186/s12890-021-01707-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Keum-Ju Choi ◽

Eun-Hyung Yoo ◽

Kyung Chan Kim ◽

Eun Jin Kim

Keyword(s):

Symptom Onset ◽

Medical Records ◽

Radiation Pneumonitis ◽

Tertiary Hospital ◽

Group Differences ◽

Organizing Pneumonia ◽

Test Results ◽

Pneumonia Severity ◽

Radiologic Findings ◽

Fluid Test

Abstract Background Organizing pneumonia (OP) can be diagnosed pathologically, and cryptogenic OP (COP) and secondary OP (SOP) have been classified by cause and particular underlying context. Because it is clinically difficult to differentiate between COP and SOP, this study investigated characteristics that could distinguish between COP and SOP. Methods The medical records of patients who underwent lung biopsy for a diagnosis of OP at a single tertiary hospital from January 2016 to December 2018 were retrospectively reviewed. Results Eighty-five patients had pathologically proven OP, including 16 diagnosed with COP and 69 diagnosed with SOP. The most common cause of SOP was infectious pneumonia, observed in 57 (82.6%) of the 69 patients, followed by cancer and radiation pneumonitis. The pathogens causing infectious pneumonia were identified in 45 (65.2%) patients. There were no differences in age, sex, and lung function between the COP and SOP groups. Median body mass index was significantly lower (P = 0.030), and median time from symptom onset to hospital admission significantly shorter (P = 0.006), in the SOP than in the COP group. Fever was more common in the SOP group (P = 0.024), and CURB 65, an index of pneumonia severity, tended to be higher in the SOP group (P = 0.017). Some laboratory results differed significantly between the two groups. Lymphocyte counts in bronchoalveolar lavage (BAL) fluid were significantly higher in the COP than in the SOP group (P = 0.012). Radiologic findings showed that effusion was more common in the SOP group (P = 0.036). There were no between-group differences in steroid use, 30 day and in-hospital mortality rates, and rates of OP outcomes and recurrences. Pneumonia recurrence rate was significantly higher in SOP patients who were than were not treated with steroids (P = 0.035). Conclusions Infection is the main cause of SOP. Symptom onset is more rapid in patients with SOP than with COP. Some blood and BAL fluid test results differed significantly in the COP and SOP groups. Pleural effusion was more common in the SOP group but there were no differences in clinical course. Recurrence in patients with SOP was more common in those who were than were not treated with steroids.

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Increased Galectin-9 Concentration and Number of CD4+Foxp3high+Cells in Bronchoalveolar Lavage Fluid of Patients with Cryptogenic Organizing Pneumonia

Lung ◽

10.1007/s00408-015-9775-x ◽

2015 ◽

Vol 193 (5) ◽

pp. 683-689 ◽

Cited By ~ 2

Author(s):

Shigeki Katoh ◽

Masaki Ikeda ◽

Hiroki Shimizu ◽

Masaaki Abe ◽

Yoshihiro Ohue ◽

...

Keyword(s):

Bronchoalveolar Lavage ◽

Bronchoalveolar Lavage Fluid ◽

Lavage Fluid ◽

Organizing Pneumonia ◽

Cryptogenic Organizing Pneumonia

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Acute fibrinous and organizing pfneumonia: two case reports and literature review

Diagnostic Pathology ◽

10.1186/s13000-021-01155-7 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Haihong Chen ◽

Yukun Kuang ◽

Xinyan Huang ◽

Ziyin Ye ◽

Yangli Liu ◽

...

Keyword(s):

Lupus Erythematosus ◽

Lung Biopsy ◽

Bronchoalveolar Lavage Fluid ◽

Case Reports ◽

Treatment Options ◽

Ground Glass Opacity ◽

Lavage Fluid ◽

Organizing Pneumonia ◽

Case Presentation ◽

Percutaneous Lung Biopsy

Abstract Background Acute fibrinous and organizing pneumonia (AFOP) is a rare histologic interstitial pneumonia pattern characterized by the intra-alveolar fibrin deposition and organizing pneumonia. Its clinical characteristics are still not well known and there is no consensus on treatment yet. Case presentation We report two female cases in their fifties diagnosed with AFOP confirmed by a second lung biopsy. Case 1 was idiopathic AFOP with manifestation of 6-week fever, dyspnea, and cough, while case 2 was secondary to systemic lupus erythematosus and fever was the major symptom. Their chest CT scans revealed bilateral multiple consolidations, predominantly in the lower lobes. Both cases were initially diagnosed with pneumonia, but did not improve after treatment with broad-spectrum antibiotics. In both cases, transbronchial biopsy and bronchoalveolar lavage fluid examination were inconclusive and the pathological diagnosis was confirmed by percutaneous lung biopsy. Both patients had a good clinical response to prednisone. Conclusions We report two rare AFOP cases to highlight the importance of awareness of this disease. We further perform the most comprehensive review to date in AFOP, including 150 patients since 2002. Consolidation was the most common imaging pattern, followed by ground-glass opacity and nodules. A lung biopsy is required for a definitive diagnosis. Corticosteroids is recommended as the most effective therapy, but treatment options should depend on the etiology and disease severity.

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Bronchoalveolar lavage fluid and blood natural killer and natural killer T-like cells in cryptogenic organizing pneumonia

Respirology ◽

10.1111/resp.12305 ◽

2014 ◽

Vol 19 (5) ◽

pp. 748-754 ◽

Cited By ~ 10

Author(s):

Despina Papakosta ◽

Katerina Manika ◽

Evdoxia Gounari ◽

George Kyriazis ◽

Theodore Kontakiotis ◽

...

Keyword(s):

Bronchoalveolar Lavage ◽

Natural Killer ◽

Bronchoalveolar Lavage Fluid ◽

Lavage Fluid ◽

Organizing Pneumonia ◽

Cryptogenic Organizing Pneumonia ◽

Natural Killer T

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Chemokine receptor CXCR3 ligands in bronchoalveolar lavage fluid: associations with radiological pattern, clinical course, and prognosis in sarcoidosis

Polish Archives of Internal Medicine ◽

10.20452/pamw.2349 ◽

2014 ◽

Vol 124 (7-8) ◽

pp. 395-402

Author(s):

Wojciech J. Piotrowski ◽

Wojciech Młynarski ◽

Wojciech Fendler ◽

Krystyna Wyka ◽

Jerzy Marczak ◽

...

Keyword(s):

Bronchoalveolar Lavage ◽

Chemokine Receptor ◽

Bronchoalveolar Lavage Fluid ◽

Clinical Course ◽

Lavage Fluid ◽

Radiological Pattern

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Outcomes among HIV-positive patients hospitalized with COVID-19

10.1101/2020.05.07.20094797 ◽

2020 ◽

Cited By ~ 5

Author(s):

Savannah Karmen-Tuohy ◽

Philip M. Carlucci ◽

Ioannis M. Zacharioudakis ◽

Fainareti N. Zervou ◽

Gabriel Rebick ◽

...

Keyword(s):

Electronic Medical Records ◽

Medical Records ◽

Bacterial Pneumonia ◽

Nearest Neighbor ◽

Clinical Course ◽

Hiv Positive ◽

Hiv Patients ◽

Hiv Coinfection ◽

Laboratory Results ◽

Immunocompromised Hosts

Background: SARS-CoV-2 infection continues to cause significant morbidity and mortality worldwide. Preliminary data on SARS-CoV-2 infection suggests that some immunocompromised hosts experience worse outcomes. We performed a retrospective matched cohort study to characterize outcomes in HIV-positive patients with SARS-CoV-2 infection. Methods: Leveraging data collected from electronic medical records for all patients hospitalized at NYU Langone Health with COVID-19 between March 2, 2020 and April 23, 2020, we matched 21 HIV-positive patients to 42 non-HIV patients using a greedy nearest neighbor algorithm. Admission characteristics, laboratory results, and hospital outcomes were recorded and compared between the two groups. Results: While there was a trend toward increased rates of ICU admission, mechanical ventilation, and mortality in HIV-positive patients, these differences were not statistically significant. Rates for these outcomes in our cohort are similar to those previously published for all patients hospitalized with COVID-19. HIV-positive patients had significantly higher admission and peak CRP values. Other inflammatory markers did not differ significantly between groups, though HIV-positive patients tended to have higher peak values during their clinical course. Three HIV-positive patients had superimposed bacterial pneumonia with positive sputum cultures, and all three patients expired during hospitalization. There was no difference in frequency of thrombotic events or myocardial infarction between these groups. Conclusion: This study provides evidence that HIV coinfection does not significantly impact presentation, hospital course, or outcomes of patients infected with SARS-CoV-2, when compared to matched non-HIV patients. A larger study is required to determine if the trends we observed apply to all HIV-positive patients.

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