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Spontaneous Regression Of Acute Fibrinous Organizing Pneumonia Induced By Covid-19 Vaccination: A Case Report

Haga, S. 2024Other/Unknown

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

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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 covid-19 vaccine. 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. Bronchoalveolar lavage fluid (balf) from the right middle lobe (b4) was clear in appearance, with a total cell count of 450 cells/ μl, and increased lymphocytes. Transbronchial lung cryobiopsy specimens from the right lower lobe (b9) led to the diagnosis of acute fibrinous organizing pneumonia (afop)

Remission Characteristics

Uscle 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

Clinical Treatment

Biopsy