Spontaneous Regression Of Acute Fibrinous Organizing Pneumonia Induced By Covid-19 Vaccination: A Case Report
Haga, S., Otoshi, R., Sekine, A., Kaneko, T., Yamada, C., Baba, T., Komatsu, S., Sawazumi, T., Takemura, T., & Ogura, T. (2024). Spontaneous regression of acute fibrinous organizing pneumonia induced by COVID-19 vaccination: A case report. Respiratory investigation, 62(3), 356–359. https://doi.org/10.1016/j.resinv.2024.01.014
View Original Source →Abstract
A 42-year-old woman visited our hospital with complaints of fever, muscle pain, and dyspnea one week after receiving the coronavirus disease 2019 (COVID-19) vaccine. Chest high-resolution computed tomography showed a patchy consolidation and ground-glass attenuation in the both lungs, consistent with acute interstitial pneumonia. Transbronchial lung cryobiopsy revealed organizing pneumonia with marked intra-alveolar fibrin, and pathologically diagnosed as acute fibrinous organizing pneumonia (AFOP). Other causative diseases such as dermatomyositis was clinically ruled out, and COVID-19 vaccine-induced AFOP was diagnosed. Physician should check the history of COVID-19 vaccination when encountering a case of AFOP with an unknown cause.
Case Details
Disease Location
Lung
Personal Characteristics
42-year-old
Clinical Characteristics
Complaints of fever, extremity muscle pain, and dyspnea one week after receiving the second dose of the bnt162b2 covid-19 vaccine. Chest x-ray showed increased opacification in right lower lung at first visit. Chest high-resolution computed tomography (hrct) showed a slight patchy consolidation and ground-glass attenuation with interlobular septal thickening in the periphery of both lungs, consistent with acute interstitial pneumonia transbronchial lung cryobiopsy specimens from the right lower lobe (b9) revealed diffuse edematous thickening of the alveolar septal wall and the peribronchial interstitium with lymphocytic infiltration. In addition, organizing pneumonia with marked intra-alveolar fibrin in the form of fibrin ‘balls’ within the alveolar spaces was observed, and the acute fibrinous organizing pneumonia (afop) was pathologically diagnosed
Remission Characteristics
Muscle symptoms and inflammatory markers resolved spontaneously after 2 weeks of admit- sion, and pulmonary involvement improved on x-ray and hrct 2 months later
Treatment & Mechanisms
Proposed Remission Mechanisms
Afop caused by the vaccination can spontaneously resolve. The prognosis of vaccine-induced afop may be favorable
Clinical Treatment
Biopsy