Akut fibrinöz ve organize pnömoni

Abstract

Akut fibrinöz ve organize pnömoni (AFOP), ilk kez histolojik olarak Beasley ve ark. tarafından tanımlanmıştır. AFOP geniş bir yaş aralığında (38-78 yaş) ve cinsiyetçi olmayan bir hasta yelpazesinde ortaya çıkmaktadır. İdiyopatik olgular bildirilse de altta yatan etiyolojinin bilindiği olgu serileri de mevcuttur. Histolojik olarak spesifik patern, organize intraalveoler fibrinin varlığıdır ve tanı için temel parametredir. AFOP ve COP karşılaştırıldığında halo bulgusu dışında radyolojik paternde anlamlı bir fark yoktur. Akut ve daha fulminan bir tabloyla başvuran hastalarda klinik hızla kötüleşen solunum yetmezliği ile karşımıza çıkmaktadır. Başlıca şikayetler sırasıyla ateş, öksürük ve göğüs ağrısıydı. AFOP bir dışlama tanısı olduğu için çoğu hastaya tedaviye yanıt vermeyen veya takip sırasında iyileşmesi geciken pnömoni tanısı konur. AFOP'un fulminan ve subakut formlarının klinik tabloları farklı olsa da fulminan formun mortalitesinin yüksek olması nedeniyle tedavide net bir ayrım yapılamamaktadır. Akut fulminan vakalarda prognoz kötüdür.

Keywords

• Organize pnömoni
• interstisyel akciğer hastalığı
• akut fibrinozis

Acute fibrinosis and organized pneumonia

Abstract

Acute fibrinous and organizing pneumonia (AFOP), first described histologically by Beasley et al.1 in 2002. AFOP occurs in a wide age range (38-78 age) and in a non-sexist spectrum of patients. Although idiopathic cases have been reported, case series in which the underlying etiology is known. The histologically specific pattern is the presence of organized intra-alveolar fibrin and is the essential parameter for diagnosis. There is no significant difference in the radiological pattern except for the halo finding in the comparison of AFOP and COP. In patients presenting with an acute and more fulminant picture, the clinic presents with rapidly worsening respiratory failure. The main complaints were fever, cough and chest pain respectively. Since AFOP is a diagnosis of exclusion, most patients are diagnosed with pneumonia that does not respond to treatment or has delayed resolution during follow up. Although the clinical presentations of the fulminant and subacute forms of AFOP are different, a clear distinction cannot be made for treatment due to the high mortality of the fulminant form. The prognosis is poor in acute fulminant cases.

Keywords

• Organized pneumonia
• interstitial lung disease
• acute acute fibrinous

References

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